- Trustmark (Sacramento, CA)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to...member PHI / HIPAA information + This is a remote position\#LI- Remote **Scheduled Weekly Hours** 40 **Pay… more
- Zurich NA (Sacramento, CA)
- …Office, AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- DIRECTOR ... Sr. Claims Specialist - Complex Construction Claims 117562 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our… more
- Centene Corporation (Sacramento, CA)
- …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Takeda Pharmaceuticals (Sacramento, CA)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure...around the world. This position is currently classified as " remote " in accordance with Takeda's Hybrid and Remote… more
- HealthEdge Software Inc (Sacramento, CA)
- **Overview** ** Director , Product Management** **Position Overview:** We are seeking a highly skilled and experienced Director of Product Management to lead our ... and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream… more
- Cardinal Health (Sacramento, CA)
- …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Humana (Sacramento, CA)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- Trustmark (Sacramento, CA)
- …benefits products (ie, sales, implementation and enrollment, underwriting, billing, servicing, claims ) using DMAIC, PDCA, etc. methods. Develop the approach and ... small, mid-size, and complex/transformational projects, with support from the Executive Director , Digital Project Manager, as needed. Define baseline and target… more
- Travelers Insurance Company (Rancho Cordova, CA)
- …Services provides industry-first resources designed to detect and deter fraudulent claims . Using some of the most comprehensive technology available, we have ... staff of up to 12 employees who may be remote . **What Will You Do?** + Accountable for office...+ Accountable for evaluations and investigations of all fraud claims ; analyzes results to determine their impact. + Establishes… more
- Sedgwick (Sacramento, CA)
- …Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Risk Services Manager - Pooling ( Remote OR Hybrid in CA) **Are you looking for an impactful job where ... of an energetic culture?** + Enjoy flexibility -Hybrid in N. California (Sacramento), remote or telecommuter setting **in California only.** + This role will require… more
- Zurich NA (Sacramento, CA)
- …AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR #LI-HYBRID ... Zurich's Philadelphia office. We are also open to hiring remote talent. This role will be filled at either...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- American Institutes for Research (Sacramento, CA)
- …to the analysis of healthcare data and provide support to the project director and/or senior team members on various tasks including querying large datasets ... including Medicare, Medicaid, and commercial payer claims data, cleaning and imputing data, creating analytic data files according to technical specifications,… more
- Zurich NA (Sacramento, CA)
- …Office, AM - Oregon Virtual Office Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LB1 #LI- DIRECTOR ... prospect/existing customer base. + Providing periodic support to the Claims Department with technical assessment of complex claims...for resume submission. Location(s): AM - Schaumburg, AM - Remote Work (US), AM - Dallas, AM - San… more
- Zurich NA (Sacramento, CA)
- …AM - Walnut Creek Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-WL1 #LI- DIRECTOR #LI-HYBRID ... and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 12 or more years of experience in the Claims or Underwriting Support areaAND + Experience with Microsoft… more
- HomeSafe Alliance (Sacramento, CA)
- …with GHC pricing requirements and report actual performance monthly to the Director of International Operations (DIOps) + Verify and assess accuracy of transit ... risks of not meeting RDDs as directed by the Director of International Operations, for all shipments that may...International Operations, for all shipments that may create inconvenience claims for HomeSafe. Formats and data requirements to be… more
- Evolent Health (Sacramento, CA)
- …Opportunities to work collaboratively with other Clinical Operation Leaders including our Director may also be available. **What You Will Be Doing:** + Reviewing ... prior authorization requests and/or relevant health care experience in claims or appeal & grievance is required. + Previous...while balancing a workload and prioritizing assignments in a remote environment. + The ability to connect to router… more