- Trustmark (Columbus, OH)
- …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
- Scripps Health (San Diego, CA)
- …quarter of our employees have been with Scripps Health for over 10 years. The Director of HMO Payment ( Claims ) Services for Scripps Health Plan, leads claims ... * Mailroom experience. **Job:** **Finance* **Organization:** **Scripps Health Corp* **Title:** * Director , HMO Claims Services* **Location:** *Central San Diego… more
- AIG (Lenexa, KS)
- Claims Complex Director Join us as a Claims Complex Director to take on key responsibilities within a world-class claims function. Make your mark in ... Claims Our Claims teams are the proven problem solvers of choice...career path. + Potential for flexible work arrangement, including remote working. + Candidates residing outside the Atlanta metropolitan… more
- Elevance Health (Atlanta, GA)
- **Business Change Director - Claims /Payment Integrity Use-Case Lead** **Location:** This position will work a hybrid model ( remote and office). Ideal ... live within 50 miles of a PulsePoint location. The **Business Change Director - Claims /Payment Integrity Use-Case Lead** is responsible for collaborating with… more
- Providence (Renton, WA)
- …Federal, State, health plan and contractual regulations and guidelines. The Executive Director Claims Operations interfaces with internal and external resources ... **Description** **THE ROLE** The Executive Director directs, manages and oversees the activities of...management of pre-suit and litigated large loss and severity claims , including early and thorough assessment of issues, proper… more
- Martin's Point Health Care (Portland, ME)
- …2015. Position Summary Job Description Position Summary: Under the supervision of the Director of Health Plan Operations, the Claims Auditor II will perform ... Martin's Point, either verbally or through written communications, regarding questions related to claims , claims audits or other matters directed to the Audit… more
- Humana (Columbus, OH)
- …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
- The Cigna Group (Bloomfield, CT)
- The Claims Strategy and Payment Integrity Senior Manager will play an important role in our Affordability strategy by providing claim payment oversight for the ... small team and report directly to the IFP Senior Director of Operations. The role is designed for an...claim administration. + Evolve SLAs and oversees business partner claims processing and auditing to ensure SLAs are met,… more
- AON (Fort Wayne, IN)
- …look like As a Claims Litigation Analyst, you will report directly to the Claims Manager and/or Claims Director working in the challenging and rewarding ... by the applicable plan documents and policies. #LI-CC1 #LI-HYBRID #LI- REMOTE 2551890 Claims Litigation Analyst K&K Insurance... Litigation Analyst, you will report directly to the Claims Manager and/or Claims Director … more
- Zurich NA (Columbus, OH)
- …(US), AM - New Jersey Virtual Office Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- DIRECTOR ... Sr. Claims Specialist - Complex Construction Claims 117562 Zurich North America is seeking a skilled and experienced Senior...AM - New York, AM - Remote Work… more
- Zurich NA (Parsippany, NJ)
- …public company Director 's and Officer's (D&O), Fiduciary and transactional risk claims of moderate to high value and complexity. The ideal candidate will have ... Legal Claims Professional- Public D&O 118491 Zurich is currently...AM - Atlanta, AM - Parsippany, AM - Addison Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered:… more
- Centene Corporation (New York, NY)
- …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Sedgwick (Miami, FL)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director - Client Services ( REMOTE ) **PRIMARY PURPOSE** : To determine ... rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability to… more
- AbbVie (Chicago, IL)
- …LinkedIn. Job Description *Position can sit remotely anywhere in the US The Director , Patient Centered Outcomes Research, is responsible for the design and execution ... functions (eg, Clinical Development & Operations, Regulatory, Commercial). The Director , Patient-Centered Outcomes Research, will support a therapeutic area and… more
- Takeda Pharmaceuticals (Columbus, OH)
- …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
- Two95 International Inc. (Atlanta, GA)
- Job Title: Director , Health Plan Analytics Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Position Summary: As ... the Director of Analytics, you will lead a team of...including but not limited to enrollment, finance, call center, claims , Case Management and Utilization Management * 5+ years… more
- Crawford & Company (Phoenix, AZ)
- …claim adjusters and other staff and oversee the analysis, review and validation of claims under the direction of the Managing Director . Ensures processes and ... is an IN-OFFICE postion that will not convert to remote . Must be local to Phoenix AZ. Responsibilities +...years of experience as an Adjuster, Adjuster in Charge, Claims Supervisor or Claims Manager. + Previous… more
- UPMC (Pittsburgh, PA)
- …a place for you. UPMC Health Plan's growing Actuary department is seeking a Director , Actuary to ensure that the UPMC Health Plan Actuarial Department provides the ... the financial reporting department to develop reserve amounts for IBNR claims , active claims and premium deficiency reserves on a regular or as-needed basis.… more
- EPAM Systems (Chicago, IL)
- …be the perfect opportunity for you to join EPAM as a **Managing Director , Insurance Advisory** . Scroll down to learn more about the position's responsibilities ... operational capabilities **Requirements** + Prior experience as a Managing Director (Partner, or equivalent level) with primary client relationship responsibility… more
- RTX Corporation (Tallahassee, FL)
- Date Posted: 2024-10-30 Country: United States of America Location: RFL99: RTN Remote , Florida Position Role Type: Remote RTX Corporation is an Aerospace and ... compliance to RTX and BU policies & FAR / DFAR requirements. + Validate claims that design requests are necessary because of contract compliance + Participate in… more