• Medical Director -- Claims

    Humana (Atlanta, GA)
    …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
    Humana (10/29/24)
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  • Assistant Claims Manager (Military Move)

    HomeSafe Alliance (Atlanta, GA)
    …best practices that enhance claims service. **About the Role** The Assistant Claims Manager role is a remote opportunity responsible for ensuring the claim ... settlement practices, trends, or areas of concern to the Director of Claims . Responds to internal and...duties as needed. **Note** : This position is fully remote / work from home. HomeSafe will supply appropriate… more
    HomeSafe Alliance (01/15/25)
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  • Director , HIV Medical Affairs - NYC…

    Merck (Atlanta, GA)
    **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages ... questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support, and… more
    Merck (12/19/24)
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  • Legal Claims Professional - Public D&O

    Zurich NA (Atlanta, GA)
    …public company Director 's and Officer's (D&O), Fiduciary and transactional risk claims of moderate to high value and complexity. The ideal candidate will have ... Legal Claims Professional - Public D&O 119736 At Zurich...Location(s): US_16 (US_16), US_09 (US_09), US_02 (US_02), US_26 (US_26) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered:… more
    Zurich NA (12/21/24)
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  • Managing Director - Insurance Advisory…

    EPAM Systems (Atlanta, GA)
    **This Remote Position Cannot be Performed in New York City.** You are a natural leader and a proven operator at the most senior levels of clients in the insurance ... - go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit,… more
    EPAM Systems (12/18/24)
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  • Director Account Management, PACE…

    Prime Therapeutics (Atlanta, GA)
    …It fuels our passion and drives every decision we make. **Job Posting Title** Director Account Management, PACE - Remote **Job Description** + Owns overall ... Management Centers (CMC) and Shared Services, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis… more
    Prime Therapeutics (12/19/24)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Atlanta, GA)
    …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
    Takeda Pharmaceuticals (01/15/25)
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  • Oncology Regional Medical Scientific…

    Merck (Atlanta, GA)
    …collaboration to further differentiate our portfolio. The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, or PharmD) therapeutic ... external medical and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs provide to… more
    Merck (01/10/25)
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  • Director , Health Plan Analytics…

    Two95 International Inc. (Atlanta, GA)
    Job Title: Director , Health Plan Analytics Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Position Summary: As ... the Director of Analytics, you will lead a team of...including but not limited to enrollment, finance, call center, claims , Case Management and Utilization Management * 5+ years… more
    Two95 International Inc. (12/10/24)
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  • Director , Senior Counsel, Regulatory…

    United Therapeutics (Atlanta, GA)
    …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... Compliance departments related to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other healthcare related laws and… more
    United Therapeutics (12/14/24)
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  • Human Resources Specialist (Leaves…

    Devereux Advanced Behavioral Health (Kennesaw, GA)
    …and behavioral health challenges. Under the direction of the People Operations Director , you will perform tasks to support the effective and efficient delivery ... Office Applications and database management. + Experience processing worker's compensation claims , FMLA, and other leave of absence cases. + Excellent communication… more
    Devereux Advanced Behavioral Health (01/09/25)
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  • Associate Director Data Science, US…

    Merck (Atlanta, GA)
    **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater ... analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization… more
    Merck (01/14/25)
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  • Medicare Grievances and Appeals Corporate Medical…

    Humana (Atlanta, GA)
    …The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services… more
    Humana (01/07/25)
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  • Director , Risk Management

    Western Digital (Atlanta, GA)
    …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... requirements. + Insure the proper and efficient handling of claims as they relate to workers' compensation insurance requirements....to be performed in California, Colorado, New York or remote jobs that can be performed in California, Colorado… more
    Western Digital (12/27/24)
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  • Regional Account Director

    Takeda Pharmaceuticals (Atlanta, GA)
    …to the best of my knowledge. **Job Description** **Regional Account Director ** **Takeda Pharmaceutical** **USA-MA-Virtual** **About the role:** Are you looking for ... you to shine? Join us as the Regional Account Director ; reporting into the Head of Corporate Accounts. This...+ Optimize payer opportunities by utilizing available resources (volume/ claims analytics, reimbursement data, etc.) at the product and… more
    Takeda Pharmaceuticals (01/16/25)
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  • Director of International, Global Household…

    HomeSafe Alliance (Atlanta, GA)
    **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
    HomeSafe Alliance (12/21/24)
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  • CE Strategic SCM Director 1

    Celestica (Atlanta, GA)
    …ID: 124191 Region: Americas Country: USA State/Province: New Hampshire City: Remote Employee US **General Overview** **Functional Area:** Supply Chain Management ... (SCM) **Career Stream:** Supply Chain Management (SCM) **Role:** Director 1 (DR1) **Job Title:** Director , Strategic...ensure capacity is installed as needed. + Supports E&O claims , shortage management and follow up escalations with customers… more
    Celestica (12/20/24)
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  • Business Change Director - End-to-end Data…

    Elevance Health (Atlanta, GA)
    **Business Change Director - End-to-end Data Governance** **Location:** Alternate locations may be considered. This position will work in a hybrid model ( remote ... of one of our Elevance Health PulsePoint locations. The **Business Change Director - End-to-end Data Governance** will be responsible for tracking, oversight &… more
    Elevance Health (01/14/25)
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  • Pricing Analyst - Remote

    Prime Therapeutics (Atlanta, GA)
    …drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides analyses, consults and ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
    Prime Therapeutics (01/09/25)
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  • PBM Sr Business Intelligence Data Visual…

    Prime Therapeutics (Atlanta, GA)
    …**Job Posting Title** PBM Sr Business Intelligence Data Visual Consultant - Remote **Job Description** The Senior Data Visualization Consultant is responsible for ... new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
    Prime Therapeutics (01/08/25)
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