- CRC Insurance Services, Inc. (TX)
- …job description:** This role is focused on technical claim handling of complex general liability claims , both litigated and non-litigated. This role requires ... affecting primary and excess policies in a fast-paced E&S Claim remote environment 2. Independently evaluating information...and underwriters in the handling and adjudication of all claims 10. Handling complex claims … more
- GuideOne Insurance (Dallas, TX)
- As the Casualty Claims Manager , you will be responsible for independently analyzing and comparing data to formulate goals and reports. You will be required to ... have 3 or more years of Commercial Claims leadership experience. In addition, this is a work...this is a work from home position leading a remote team. Accountabilities: + Provides direction to claim… more
- Lincoln Financial Group (Austin, TX)
- …You will oversee and ensure the fair, ethical and timely management of more complex claims . If you are passionate about Supplemental Health Claims , ... the processing and administration of all aspects of more complex claims for their assigned area(s) of... claim management. + Approves and makes more complex claim management related financial decisions consistent… more
- Elevance Health (Grand Prairie, TX)
- … auditor procedure manuals for accuracy. + Independently analyzes and makes decisions on complex claim audit issues. + Serves as subject matter expert on policy, ... Auditor Lead** _This position will work a hybrid model ( remote and office), 1-2 times per week. The Ideal...and other audit teams. + Partners with Management on complex claims reviews and resolution. + Responsible… more
- Molina Healthcare (Fort Worth, TX)
- **Job Description** **Job Summary** The Lead Risk and Quality Performance Manager supports Molina's Risk & Quality Solutions (RQS) team by overseeing large programs ... program changes and ensure alignment with program goals. * Resolve complex problems through project management, data analytics, and stakeholder collaboration. *… more
- Molina Healthcare (Houston, TX)
- **Job Description** **Job Summary** The Sr Risk & Quality Performance Manager is a tactical execution role that will lead specific projects to support Molina's Risk ... effective relationships and gain their trust and respect. * Resolve complex problems through project management, data analytics, and stakeholder collaboration. *… more
- Molina Healthcare (Fort Worth, TX)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... and Project * Experience partnering with various levels of leadership across complex organizations * Strong quantitative aptitude and problem solving skills *… more
- The Hartford (San Antonio, TX)
- …candidate for the Medical Case Manager role will oversee disability claims with complex medical conditions referred for medical assessment, clarification of ... the review of Long-Term Disability (LTD) and Short-term Disability claims with complex medical conditions referred for...and/or case management. + Work closely with the STD/LTD Claims Team to identifying appropriate claim referrals… more
- The Hartford (San Antonio, TX)
- …comprehensive evaluation of a disability claimant functionality. + Advises on highly complex claims at multidisciplinary clinical review roundtables to ensure ... physician reviews, home assessments, etc. + Manages risk and resources on highly complex behavioral health claims . + Identifies appropriate return to work… more
- Zurich NA (Austin, TX)
- …+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims . + Ability to follow reserving process for indemnity and ... claims at the highest authority levels on commercial claim assignments reflecting the highest degree of technical complexity,...expense in analyzing the potential exposure of complex claims . + Ability to determine the… more
- Prime Therapeutics (Austin, TX)
- …we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of value ... or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic insight to… more
- Prime Therapeutics (Austin, TX)
- …drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides analyses, consults and ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
- Prime Therapeutics (Austin, TX)
- …**Job Posting Title** PBM Sr Business Intelligence Data Visual Consultant - Remote **Job Description** The Senior Data Visualization Consultant is responsible for ... new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
- Prime Therapeutics (Austin, TX)
- …Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims ... and drives every decision we make. **Job Posting Title** Underwriter - Remote **Job Description** The Underwriter is responsible for assisting in the development… more
- Prime Therapeutics (Austin, TX)
- …we make. **Job Posting Title** Senior Business Integration Consultant - Remote **Job Description** The Senior Business Integration Consultant is responsible for ... leading multiple complex small to mid-sized client and/or product implementations, projects,...Proficiency in one or more of the following areas: claims , eligibility, prior authorization, accumulators, and/or benefits + Previous… more
- CVS Health (Austin, TX)
- …and deliver solutions to make health care more personal, convenient and affordable. **This Case Manager RN role is with the Costco Team and is fully remote ; ... **No weekends or holidays will be required** The Case Manager RN is responsible for telephonically and/or face to...designed to reduce risk factors and barriers and address complex issues and social indicators which impact care planning… more
- Chenega Corporation (San Antonio, TX)
- …(eg, claim processing operations) to correct problems. + Review claims returned by federal components (Office of Disability Operations/Disability Quality Board) ... The **Disability Review Analyst** is responsible for conducting reviews of disability claims competed by Medical and Psychological consultants and assisting with the… more
- UNUM (Austin, TX)
- …and join Team Unum today! **General Summary:** The Home Office National Client Manager (HO NCM) is responsible for maintaining a consultative relationship with ... complex group, VB, and integrated customers with 2,000 or...one single large client on the west coast. Existing remote or field office employees are eligible to apply.… more
- Sysco (Houston, TX)
- **JOB SUMMARY** The Manager , Food Safety Program (Food Safety Program Manager (FSPM)) is responsible for providing proactive leadership and instruction in Food ... assigned to FSPMs based on risk and complexity. The Manager , Food Safety Program (Food Safety Program Manager...potential for food safety issues and to support the Claims Process with Sysco's 3rd party claims … more
- AECOM (Dallas, TX)
- …infrastructure consulting firm, partnering with clients to solve the world's most complex challenges and build legacies for future generations. There has never been ... us. **Job Description** **AECOM** is seeking a **Construction** **Project Manager - Aviation** to be based in Dallas, Houston,...and minimize client exposure. + Proactively work to avoid claims and resolve claims expeditiously to minimize… more