- Trustmark (Albany, NY)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to...member PHI / HIPAA information + This is a remote position\#LI- Remote **Scheduled Weekly Hours** 40 **Pay… more
- Merck (Albany, NY)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages ... questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support, and… more
- Takeda Pharmaceuticals (Albany, NY)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure...around the world. This position is currently classified as " remote " in accordance with Takeda's Hybrid and Remote… more
- United Therapeutics (Albany, NY)
- …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... Compliance departments related to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other healthcare related laws and… more
- Western Digital (Albany, NY)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... requirements. + Insure the proper and efficient handling of claims as they relate to workers' compensation insurance requirements....to be performed in California, Colorado, New York or remote jobs that can be performed in California, Colorado… more
- HomeSafe Alliance (Albany, NY)
- **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
- CDPHP (Albany, NY)
- …and invites you to be a part of that experience. The Medical Director , Behavioral Health, Child & Adolescent Programs will conduct utilization review oversight, ... across all lines of business. In addition, the Medical Director will be assigned to oversee the unique needs...Excel, Outlook and PowerPoint is required. + Knowledge of claims management systems is preferred. + Ability to learn… more
- Mathematica (Albany, NY)
- …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
- Alaant (Latham, NY)
- …plays a critical role in managing and resolving workers' compensation claims . This includes investigating claims , evaluating coverage, identifying potential ... You will be responsible for adjusting indemnity and medical claims , with a focus on closed periods of lost...(after training period) 3 days in office / 2 remote + Salary: $58,000 - $62,000 / year +… more
- Zurich NA (Albany, NY)
- …AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR #LI-HYBRID ... Zurich's Philadelphia office. We are also open to hiring remote talent. This role will be filled at either...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- SitusAMC (Albany, NY)
- …and leader development, policy administration and compliance with support from Director + Ensures adherence to policies and procedures regarding employee relations, ... coaching, counseling, career development, and disciplinary actions. + Handles unemployment claims ; front line benefit questions, helps leaders write or update job… more
- HomeSafe Alliance (Albany, NY)
- …with GHC pricing requirements and report actual performance monthly to the Director of International Operations (DIOps) + Verify and assess accuracy of transit ... risks of not meeting RDDs as directed by the Director of International Operations, for all shipments that may...International Operations, for all shipments that may create inconvenience claims for HomeSafe. Formats and data requirements to be… more
- Evolent (Albany, NY)
- …Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. **What You Will Be Doing:** + Reviewing ... prior authorization requests. Or relevant health care experience in claims or appeal & grievance is required. + Ability...while balancing a workload and prioritizing assignments in a remote environment. + The ability to connect to router… more