- 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
- Molina Healthcare (Phoenix, AZ)
- …including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure ... knowledge/skills/abilities:** * Establishes and maintains benefits, provider contracts, fee schedules, claims edits, and other system settings in the claim payment… more
- USAA (Phoenix, AZ)
- …Decision Science Analysts and be responsible for delivering insights to the Claims organization related to service, efficiency, and workflow opportunities. They will ... closely collaborate with Claims and Enterprise partners to deliver on ...communication and presentation skills, including the ability to convey complex analytical insights to non-technical business partners. + Ability… 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
- Microsoft Corporation (Phoenix, AZ)
- …claims management processes. This role reports to the Microsoft CO+I EPC GSC Senior Director of Global Claims and works seamlessly with the Regional Claims ... The **Senior Construction Claims Analyst** shall work seamlessly with the Global...Claims . This team supports a global portfolio of complex , multi-disciplinary, multi-billion-dollar, multi-year datacenter construction projects across all… 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
- 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
- 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
- Merck (Phoenix, AZ)
- **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
- Microsoft Corporation (Phoenix, AZ)
- …for Microsoft's cloud business. The MS portfolio consists of complex , multi-disciplinary, large scale, multi-year datacenter construction and lease projects. ... CO+I, Datacenter business is looking to fill the role of **Regional Contracts Quality Director ** for Americas. The Contracts Quality director has a role in… more
- Microsoft Corporation (Phoenix, AZ)
- …for Microsoft's cloud business. The MS portfolio consists of complex , multi-disciplinary, large scale, multi-year datacenter construction and lease projects. ... The CO+I, Datacenter business is looking to fill the role of Global **Contracts Quality Director ** . The Contracts Quality director has a role in overseeing and… 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 ... 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… 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
- Zurich NA (Phoenix, AZ)
- …+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims . + Ability to follow reserving process for indemnity and ... expense in analyzing the potential exposure of complex claims . + Ability to determine the...Remote Work (US) Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LC1 #LI- DIRECTOR … more
- Zurich NA (Phoenix, AZ)
- …claims specific to your Line of Business. + Develop strategies for resolving complex claims , ensuring proper and timely reserving. + Work with external ... + Represent Zurich in medical bill dispute hearings. + Review and assess complex claim documents, including complaints, answers, motions to dismiss, and other legal… 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
- Prime Therapeutics (Phoenix, AZ)
- …new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to ... based upon large data sets and/or experience working with complex queries + 3 years of experience with dashboard...+ Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data… more
- Zurich NA (Phoenix, AZ)
- …Liability Underwriter, (Sr. Level III or AVP Level IV) you will handle complex new and renewal domestic Construction Professional Liability accounts and serve as a ... Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate… more
- Prime Therapeutics (Phoenix, AZ)
- …with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness & ... accuracy of Prime's financial pricing programs against adjudicated claims to identify trends and draw insights to provide...accuracy + Demonstrated ability to problem solve and interpret complex data + Ability to work independently and meet… 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