- Humana (Phoenix, AZ)
- … 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
- Banner Health (Phoenix, AZ)
- …and a minimum of five to seven years medical professional liability management experience, either as in-house claims professional or outside counsel. Must ... Mgmt **Work Shift:** Day **Job Category:** Legal The **Executive Director , Claims & Litigation Counsel** will provide...leadership experience with healthcare risk management , quality management , in house liability claims management… more
- Caris Life Sciences (Phoenix, AZ)
- …and develop relationships to targeted National Payer key stakeholders from medical director , network management , and claims management . + Inform ... in-network contracts with National Payers. + Manage BCBS Caresourcing relationship. + With medical policy team, drive improved medical policies and adoption of… more
- Humana (Phoenix, AZ)
- …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
- Humana (Phoenix, AZ)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Evolent Health (Phoenix, AZ)
- …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… more
- Dignity Health (Phoenix, AZ)
- …+ Experience with third party claim resolution processes including denials and appeals management , adjudication of claims required + 3+ years of acute care ... heart of Phoenix, Arizona, (http://phoenix.gov/visitors/index.html) St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital that provides a… more
- USAA (Phoenix, AZ)
- …synthetic fraud and account takeover attempts + Closely partner with Strategies team, and Director of Fraud Model Management and Model Users on model builds and ... techniques to identify criminal networks engaging in fraud, scams, disputes/ claims and AML and deliver highly significant benefits +...and improve Member experience + In partnership with the Director of Model Management , quantify the value… more
- J&J Family of Companies (Phoenix, AZ)
- …safety data, international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and implements ... Associate Director , Signal Detection Scientist - 2406212640W **Description** Johnson...position is to lead the implementation of the Signal Management Group's aggregate surveillance strategies for proactive and systematic… more
- Cardinal Health (Phoenix, AZ)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- Marriott (Chandler, AZ)
- …improvement. **Conducting Human Resources Activities** * Assists in minimizing cost of accident claims through aggressive claims management . * Brings issues ... **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** Manages security/loss prevention operations on a daily… more
- Sumitomo Pharma (Phoenix, AZ)
- …a dynamic, highly motivated, and experienced individual for the position of ** Director , Market Access Insights** to support US Market Access strategic and tactical ... navigating complex organizational structures / experience in highly matrixed environments. The Director will be a member of the Commercial Insights team. This… more
- Takeda Pharmaceuticals (Phoenix, AZ)
- …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
- Evolent Health (Phoenix, AZ)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- USAA (Phoenix, AZ)
- …other. Come be a part of what makes us so special! As a dedicated Director of Bank Business Process Consultant in Disputes, you will direct managers who manage teams ... of USAA and our members by conducting investigations of member claims , researching, analyzing, and processing dispute inquiries for financial transactions related… more
- Evolent Health (Phoenix, AZ)
- …models using healthcare data (ie, both structured and unstructured data from operations, claims , and medical charts) to solve complex problems, drive innovation, ... in everything from scrubs to jeans. **Position summary** As an Associate Director , Data Scientist (Machine Learning Engineer), you will be responsible for… more
- USAA (Phoenix, AZ)
- …leadership and strategic direction to the Survivor Relations team and senior management to ensure quality advocacy and an exceptional member experience related to ... enterprise initiatives, programs, and policies. . Partners with VP, Survivorship and Claims to establish annual department budget and continually monitors costs and… more
- Aveanna (Phoenix, AZ)
- …and certifications) Creating and providing monthly evaluation and skills report to Director (s) Coordinate with Corporate Risk Management and Leave of Absence ... Operations Specialist - Medical Records & Payroll ApplyRefer a FriendBack Job...accuracy and within Premier time frames Assists the Clinical Director with maintaining compliance as directed Actively listens and… more
- HomeSafe Alliance (Phoenix, AZ)
- **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 (Phoenix, AZ)
- …arranges for health care service delivery under the direction of the 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. **Required Qualifications** **** - 2 years… more