- Ryder System (Columbia, SC)
- …of assigned staff. Assists Director with other staff as directed. Work with Director and other management team to develop tactics and strategies to achieve ... staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues....annual metrics and other KPI's + Participates with the Director in the selection and management of… more
- Humana (Columbia, SC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Columbia, SC)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Centene Corporation (Columbia, SC)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Merck (Columbia, SC)
- **Job Description** The Hematology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, or PharmD) therapeutic and disease expert who ... engages in scientific exchange with leaders in the external medical and scientific community. Scientific exchange does not include promotional claims about any… more
- BD (Becton, Dickinson and Company) (Sumter, SC)
- **Job Description Summary** The Plant Associate Quality Director serves as the Plant Management Representative and as a member of the site leadership team with ... of possible** BD is one of the largest global medical technology companies in the world. _Advancing the world...**maker of possible** with us. The Plant Associate Quality Director serves as the Plant Management Representative… more
- Mass Markets (SC)
- …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... the industry. We are seeking a seasoned and driven Director of Sales to join our team. The ideal...Exceptional attention to detail. + Strong organizational and time management skills to thrive in a fast-paced environment. +… more
- Prime Therapeutics (Columbia, SC)
- …our passion and drives every decision we make. **Job Posting Title** Senior Director of Underwriting - REMOTE **Job Description** The Sr. Director Underwriting ... for prospective clients and new customer acquisitions. **Responsibilities** + Analyze claims data and develop cost-of-care projections for existing customer renewals… more
- Mass Markets (SC)
- …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... will be a results-driven leader with extensive experience inBPO operations management , strong problem-solving abilities, and a commitment to customer satisfaction.… more
- Trustmark (Columbia, SC)
- …+ Collaborate with the sales leadership teams of VP of Sales & Client Management , Senior Directors' Sales, and the whole sales team to maximize opportunities. + ... accounting of activities and sales. + Collaborate with and support the Client Management team to assure persistency goals are being achieved. + Review national… more
- Ross Stores, Inc. (Fort Mill, SC)
- …PURPOSE:** Responsible for contractual administration, procurement analytical support, claims recovery, rate filing activities and controls representing financial ... activities across all modes and transportation providers in support of: Transportation Claims Administration with a value of over $2\.5M\. Contract management … more
- Techtronic Industries North America, Inc. (Anderson, SC)
- …SC office for a **Product Safety Forensics Engineer** reporting to the Sr. Director of Product Safety. This position provides direction during all phases of product ... modification and distribution for all product lines via participation on and management of the Product Safety Committee during routine and special product reviews.… more
- Intermountain Health (Columbia, SC)
- …on-going credentialing / privileging process and other administrative functions for the Medical Staff, Medical Director , Administration, and Allied Health ... assistant- + Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within four (4) years of… more
- US Tech Solutions (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... and established clinical criteria to service requests or provides health management program interventions. + Utilizes clinical proficiency, claims … more
- ManpowerGroup (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis,… more
- US Tech Solutions (Columbia, SC)
- …at our level. + If not, then it would be sent for review with our medical director . We would then complete the approval or denial and notify the provider. ... decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. + May provide any of the… more
- Stantec (North Charleston, SC)
- … activities as assigned by and in support of Project Manager / Project Director . + Conducts budget and schedule management . + Participate in activities of ... and claims . + Reports to Project Manager / Project Director . **Qualifications** **Your Capabilities and Credentials** + Strong computer skills and literacy… more
- UIC Government Services and the Bowhead Family of Companies (Wedgefield, SC)
- …Enlisted Terminal Attack Controller (ETAC) or Air Traffic Controller (ATC), Weapons Director , a previous range control officer or equivalent test experience. + ... Military or civilian experience in the management , supervision or control of air operations on a...characteristics EOE/AA/M/F/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Evolent (Columbia, SC)
- …to both members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . ... necessary/required. + Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as… more
- Healthfirst (SC)
- …productivity and quality for each Specialist against expectations + Prepare cases for Medical Director Review ensuring that all pertinent information (ie case ... + Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management /case management .… more