- Lincoln Financial Group (Santa Fe, NM)
- …**Requisition #:** 72954 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... Group Protection in a remote environment. Background Details The Claimant Excellence Team will...development to perform in this fast-paced environment. As a Claims Customer Care Associate , you… more
- Takeda Pharmaceuticals (Santa Fe, NM)
- …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- J&J Family of Companies (Santa Fe, NM)
- Associate Director, Signal Detection Scientist - 2406212640W **Description** Johnson and Johnson is currently seeking an ** Associate Director, Signal Detection ... NJ; Raritan, NJ; Horsham, PA; OR High Wycombe, UK. Remote work options in the US or UK may...international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and… more
- Humana (Santa Fe, NM)
- …for an experienced medical coding auditor to (suggest: review inpatient hospital claims for proper reimbursement) handle provider disputes in a result-oriented and ... payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments....**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Humana (Santa Fe, NM)
- …health first** Humana's Clinical Analytics Team is seeking a Research Scientist 2 ( Remote ). Healthcare is rapidly changing, and our members are living longer, often ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
- Humana (Santa Fe, NM)
- …objective evaluation of physician performance related to our two key metrics: Efficiency of Care (cost) & Effectiveness of Care (quality). Humana is seeking a ... understanding of physician networks, physician performance and rating metrics ( claims , measures, conditions, specialties, etc.), product offerings, and analytics-based… more
- Humana (Santa Fe, NM)
- …Science, finance, Statistics, Economics or related field + Experience working with Claims , Billing and Reconciliation or related healthcare data + Expertise in ... and Root Cause Analysis (RCA) experience **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring process for this… more
- Evolent Health (Santa Fe, NM)
- …role either requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal & grievance. - **Required** ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...with other Client Service Leaders including our Client Service Associate Director and Director may also be available. **What… more
- Humana (Santa Fe, NM)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more