- Sedgwick (Phoenix, AZ)
- …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director - Complex Claims **PRIMARY PURPOSE** **:** To be ... responsible for the day to day activities of the complex claims unit, to assess the work done by the unit, and develop and improve the individuals within the… more
- Banner Health (Phoenix, AZ)
- …effectiveness of risk mitigation strategies. 9. Oversight for investigation and evaluation of complex claims and manages such claims through mediation and/or ... Claims Mgmt **Work Shift:** Day **Job Category:** Legal The **Executive Director , Claims & Litigation Counsel** will provide strategic and operational… more
- Humana (Phoenix, AZ)
- …understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Phoenix, AZ)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Humana (Phoenix, AZ)
- …relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation and… more
- Dignity Health (Phoenix, AZ)
- …St. Joseph's is considered a sought-after destination hospital for treating the most complex cases from throughout the world. Every day, approximately 20 percent of ... proud_ _to be_ _a tobacco-free campus._ **Responsibilities** **Job Summary:** The Market Director of Revenue Cycle reports directly to the Region Vice President of… more
- Celestica (Phoenix, AZ)
- …Supply Chain Management (SCM) **Career Stream:** Supply Chain Management (SCM) **Role:** Director 1 (DR1) **Job Title:** Director , Strategic Supply Chain ... dynamic market environment. **Detailed Description** We are currently seeking a ** Director , Strategic Supply Chain Management (Capital Equipment)** to join our team… more
- Nammo Defense Systems, Inc (Mesa, AZ)
- Nammo Defense Systems seeks an experienced accountable, action-oriented, and collaborative Director of Programs with a strong background in both Contract Management ... The ideal candidate will bring proven expertise in overseeing complex defense and commercial contracts and possess a strategic...production programs. How you will be rewarded as a Director of Programs * Medical, dental, vision, STD. LTD,… more
- Humana (Phoenix, AZ)
- …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
- Molina Healthcare (Phoenix, AZ)
- …years leadership/supervisory experience required * Progressive management experience to manage complex work systems and workflows required * Knowledge of pre-edit ... Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare, Medicaid,… more
- Prime Therapeutics (Phoenix, AZ)
- …or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic insight to ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Zurich NA (Phoenix, AZ)
- …Construction Casualty Underwriter, (Sr. Level III or AVP Level IV) you will handle complex new and renewal domestic Large Casualty accounts and serve as a Subject ... and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...AM - Scottsdale Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR … more
- Stantec (Chandler, AZ)
- …with Earned Value management and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. ... be based on Project/Client needs as well as proactive Claims /Risk mitigation. + Oversee and approve the development and...(PGC) Monthly Reports; issue following review with the Design Director . + Responsible for the formulation of the Project… more
- Mathematica (Phoenix, AZ)
- …data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and ... and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through… more
- Prime Therapeutics (Phoenix, AZ)
- …Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims ... and ability to adjust focus **Reporting Structure** + Reports to Manager or Director in the Finance Department Potential pay for this position ranges from $59,000.00… more
- Prime Therapeutics (Phoenix, AZ)
- …The Senior Business Integration Consultant is responsible for leading multiple complex small to mid-sized client and/or product implementations, projects, analysis, ... and external leaders + Ability and desire to drive solutions for complex business needs (including operational and technical aspects) + Familiarity with project… more
- Prime Therapeutics (Phoenix, AZ)
- …You would be tasked with helping to develop, build and manage complex clinical product initiatives.** The Principal Clinical Program Pharmacist is responsible for ... as established. **Responsibilities** + Understand, develop, build and manage complex clinical product initiatives including clinical criteria and associated data… more
- Prime Therapeutics (Phoenix, AZ)
- …**Preferred Qualifications** + PBM (Pharmacy Benefit Management) experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, ... analysts + Develop analytic methodologies, models, reports and new products + Lead complex client analytical work efforts and serve as an internal subject matter… more
- Evolent (Phoenix, AZ)
- …health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek ... plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek… more
- Evolent (Phoenix, AZ)
- …health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek ... Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. **What You Will Be Doing:** + Reviewing… more