- Humana (Richmond, VA)
- … 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
- Elevance Health (Norfolk, VA)
- **Business Change Director - Claims /Payment Integrity Use-Case Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates ... 50 miles of a PulsePoint location. The **Business Change Director - Claims /Payment Integrity Use-Case Lead** is responsible for...continue to improve on the process. The Business Change Director is responsible for working with management … more
- Dollar Tree (Chesapeake, VA)
- …regular reports to the Director , Risk Management , and VP, Risk Management on the status of claims and recovery efforts. * Special projects assigned ... systems, and software programs that are commonly utilized in claims management . * Ability to interpret and...management . * Ability to interpret and analyze investigative, medical , legal, and other reports to support claims… more
- USAA (Chesapeake, VA)
- …part of what makes us so special! **The Opportunity** We are seeking a dedicated Claims Litigation Case Manager Senior. This position is a hybrid work type and can ... resource for colleagues with less experience. + Applies advanced knowledge of claims litigation processes. + Proactively manages litigation and acts as liaison with… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …damages following an event. + Design, implement, and maintain organizational systems for claims management and occurrence reporting with the goal of reducing ... The Risk Director assesses, plans, implements, and directs the Risk Management activities of the organization. The Risk Director works collaboratively with… more
- Humana (Richmond, VA)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Humana (Richmond, VA)
- …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
- Sedgwick (Richmond, VA)
- …+ Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director , Network Operations **PRIMARY PURPOSE** : To be responsible for the… more
- Elevance Health (Norfolk, VA)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... This high-performing individual contributor will be responsible for working with management to identify and implement varied projects, programs and plans that… more
- Cardinal Health (Richmond, VA)
- …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Sedgwick (Richmond, VA)
- …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Client Services Director - Casualty | CST & EST Time Zones...EST Time Zones **PRIMARY PURPOSE** : To determine account management strategies related to client service plans; to be… more
- Thrive Proactive Health (Virginia Beach, VA)
- …career advancement. We are looking for a Lead Physical Therapist and/or Clinic Director to help lead and run our physical therapy department. Ideal candidate enjoys ... entrepreneurial spirit. Will help be responsible for the direct management and oversight of assigned team members and assist...being a subject matter expert and working with Marketing Director to assure ongoing incoming leads and referrals to… more
- Elevance Health (Norfolk, VA)
- …Platforms that are enabled across Carelon's Product Portfolio, inclusive of medical benefits management products, behavioral health products, payment integrity ... products, pharmacy benefit management products, specialty risk products, utilization management and prior authorizations. This Director will look across the… more
- UIC Government Services and the Bowhead Family of Companies (Springfield, VA)
- …Business Line and our Army Cyber market operations. As a Business Development Director , you will be responsible for brand awareness, building, managing, and maturing ... or equivalent combination of education plus five (5) years operations/project management experience and/or business development experience in a government setting. *… more
- Takeda Pharmaceuticals (Richmond, VA)
- …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
- Southland Industries (Dulles, VA)
- …Lead workers' compensation and insurance efforts at the division level, ensuring proper claims management and proactive risk mitigation. + Develop and advise ... **POSITION SUMMARY** As the Division Safety Director , you will oversee all aspects of Safety...safety issues, regardless of level in the organization. **Talent Management and Development:** + Foster a collaborative and supportive… more
- Huntington Ingalls Industries (Newport News, VA)
- CORPORATE DIRECTOR AND ASST GENERAL COUNSEL 2 Location: Newport News, Virginia, United States Date: Oct 30, 2024 Req ID: 39185 Team: N358 LEGAL Entity: HII Corporate ... seeks an experienced and dynamic attorney to act as Director and Assistant General Counsel at its Newport News...and training to NNS's Contracts and Pricing and Business Management organizations on all aspects of government contracting including… more
- CVS Health (Richmond, VA)
- …health care more personal, convenient and affordable. **Position Summary:** **The Lead Director , Operations (hiring for two positions)** plays a key role by leading ... executive, providers, and administrative staff. + Relationship building + Medical cost, risk, and quality analysis + Transforming data...in a care delivery setting, population health and care management + 5+ years of strong Medicare and clinical… more
- Guidehouse (Arlington, VA)
- …areas: + Project governance, eg organizational and process aspects + Risk management and analysis, eg risk register, quantitative (probabilistic) risk modeling, root ... cause analysis, issue management , prudency reviews + Construction project management ...common commercial terms, procurement processes, administration, scope control, construction claims + Performance metrics and project reporting + Project… more
- Wells Fargo (Roanoke, VA)
- …Analytics Team. A part of the Chief Operating Office under Fraud and Claims Operations, the team provides analytic support and internal fraud detection capabilities ... including, but not limited to, Model Risk, Fraud Risk and Allegations Management . This position will have direct interaction/engagement with independent risk … more