- Humana (St. Paul, MN)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Sedgwick (St. Paul, MN)
- …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 ... negotiation, mediation, arbitration, or ADR skills on higher value complex claims . Management experience preferred. Specific jurisdictional expertise required.… more
- Humana (St. Paul, MN)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Conviva (St. Paul, MN)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Physician Leadership in Population Health Strategy at Primary Care Organization. The Medical Director conducts Utilization Management of the care received by… more
- Humana (St. Paul, MN)
- … 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
- Merck (St. Paul, MN)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Humana (St. Paul, MN)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Fairview Health Services (St. Paul, MN)
- **Overview** The Director of Revenue Cycle provides leadership and accountability for operational excellence of one or more of the major functions within Revenue ... Cycle. The Director of Revenue Cycle will implement effective strategies to...Job Description** **Job Expectations:** + Provides Strategic Direction for management of the Charge Description Master (CDM) and fee… more
- AECOM (Minneapolis, MN)
- …Leads integration of risk/change management processes during delivery, including claims management . + Ensure that project controls measures are implemented. ... select large or complex assignments. + Lead or assist with dispute resolution, claims , and other conflict management issues. + Facilitate planning activities,… more
- HomeSafe Alliance (St. Paul, MN)
- **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
- Baylor Scott & White Health (St. Paul, MN)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… more
- Takeda Pharmaceuticals (St. Paul, MN)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Fairview Health Services (Minneapolis, MN)
- …and Execution (35%):** + Involved in the development, implementation, and management of a comprehensive, market-based payer strategy. + Direct innovative programs, ... risk methodology and algorithms, data analytics, and health outcomes research. **Account Management & Sales (20%)** + Account and relationship management of… more
- Washington County (Stillwater, MN)
- …JOB SPECIFICS The Risk & Benefits Manager is responsible for oversight and management of the County employee benefits, safety, and risk management programs ... professional level expertise with self-insurance. + Experience handling work comp claims , data breaches and liability exposures. + Supervisory experience. + Prior… more
- HomeSafe Alliance (St. Paul, MN)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- CVS Health (St. Paul, MN)
- …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers,...- May assist in the research and resolution of claims payment issues. - Supports the administration of the… more
- Evolent (St. Paul, MN)
- …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
- Evolent (St. Paul, MN)
- …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- AON (Bloomington, MN)
- …to internal and external clients. + Working with the Resident Managing Director , leads critical best practice client management efforts including Strategic ... to assist clients in unusual circumstances such as large claims , etc. + Helps resolve internal issues with geographies,...and external clients. + Working with the Resident Managing Director , leads critical best practice client management … more
- Prime Therapeutics (St. Paul, MN)
- …with data consolidation and modeling + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... **Responsibilities** + Under general supervision, analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more