- Sutherland Global Services (Tallahassee, FL)
- …guidelines + Follow up on claims needing additional information + Refer problem claims to a Lead and/or auditor for additional review + Make sure that ... performance. Delivering measurable results._ This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator determines how much… more
- Windstream Communications (Tallahassee, FL)
- …risk management systems preferred. + Casualty claims handling as an adjuster or claims Team Lead or Supervisor experience. + Previous experience in a risk ... as a crucial liaison between Windstream employees, customers, and our Third-Party Claims Administrator (TPA). The role involves managing Third-Party Auto and General… more
- J&J Family of Companies (Tallahassee, FL)
- …aligned + Author the development of go-to-market strategy, value proposition and key claims + Lead successful commercial and operational introduction of new ... offering and market approach **Roadmap & Business Plan Development:** + Lead development of the business plan, initial value proposition, go-to-market approach,… more
- Humana (Tallahassee, FL)
- …caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy for pharmacy ... point of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations...update and maintain various reports and policy/procedure documents. + Lead projects with internal/external areas related to required process… more
- Sedgwick (Tallahassee, FL)
- …Workplace(R) Forbes Best-in-State Employer Performance Assurance Analyst - Property Claims (Part Time Opportunity) **PRIMARY PURPOSE** **:** Performs comprehensive ... reviews on personal and commercial lines claims of varying degree of severity (up to approximately...and provides training and improvement opportunities to the Team Lead to meet established operational and technical audit requirements.… more
- Prime Therapeutics (Tallahassee, FL)
- …fuels our passion and drives every decision we make. **Job Posting Title** Claims Technical Analyst, Sr. **Job Description** The Senior Claims Technical Analyst ... is responsible for serving as the claims analysis resource for assigned operations teams. This role is responsible for performing complex and escalated client,… more
- Guardian Life (Tallahassee, FL)
- The **Team Leader, Absence Claims Management** is responsible for leading a team of Absence Management Case Managers to get results within their team and the ... submit process improvement ideas to revise workflows and procedures. + Support claims initiatives by encouraging/providing relevant feedback and acting as a change… more
- Humana (Tallahassee, FL)
- …innovate + **Additional Information** Typically reports to a Director of Health Services, Lead , or Corporate Medical Director, depending on size of region or line of ... business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. Some medical directors may join a centralized team for… more
- Sedgwick (Tallahassee, FL)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Team Lead **PRIMARY PURPOSE** : To supervise the operation of multiple teams of ... examiners and technical staff for Auto liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to… more
- Jacobs (Tallahassee, FL)
- …/risks mitigation, initiate claims and dispute resolution, and provide response to claims notifications. * Interface with AD lead and Operations. * Oversee ... and provide inputs to the development, baselining, and tracking of the design schedule. * Before Project award assist in bid preparation, contract negotiation, risk analysis, and pricing of design fees. * Be responsible for change management including change… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Lead Automation Engineer identifies and implements solutions (hardware and software) for improvement ... operational efficiency, reduce manual processes, and improve accuracy in insurance claims processing, policy management, and other key areas. A strong background… more
- Lincoln Financial Group (Tallahassee, FL)
- …processes for efficiency, effectiveness, and reduced risk. **What you'll be doing** + You will lead the Death Claims and Money Out teams in an environment that ... As the Operations Manager, you will manage RPS Death Claims and RPS Money Out teams. You will oversee...You will partner and build relationships cross functionally that lead to providing an exceptional customer experience. You will… more
- Humana (Tallahassee, FL)
- …help us put health first** Humana's Clinical Analytics Team is seeking a Lead Research Scientist (Remote). Healthcare is rapidly changing, and our members are living ... to shape Humana's future enterprise clinical strategies and initiatives. The Lead Research Scientist will lead identification, evaluation and development… more
- Humana (Tallahassee, FL)
- …and cost-effective care for our members. We are seeking a Clinical Investigation Lead to provide strategic direction to drive appropriate care, with the aim of ... to bring forth a pipeline of potential initiatives. **Location:** remote In this lead role you'll have the opportunity to analyze complex business and clinical… more
- Takeda Pharmaceuticals (Tallahassee, FL)
- …therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the development and implementation of ... Cross-Functional Team (GLOC) + In alignment with TAU/MPD Labeling Lead , coordinates the process to obtain labeling approval by...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Takeda Pharmaceuticals (Tallahassee, FL)
- …with immunologic, hematologic, and other complex diseases. The Director, Global Labeling Strategy Lead is a key role in the PDT R&D organization accountable for the ... issues to Global Labeling management and the Global Regulatory Lead (GRL) and proposes risk mitigation strategies for assigned...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- SMX (Tallahassee, FL)
- Lead Buyer (3727)at SMX(View all jobs) (https://www.smxtech.com/careers/) United States SMX is seeking a skilled ** Lead Buyer** to provide buying support for our ... order. * Negotiates and settles with vendors regarding damage claims , rejections, losses, return of materials, overages, cancellations, and...* Provides guidance to less experienced Buyers. * May lead a small team of Buyers on large programs… more
- Humana (Tallahassee, FL)
- …services. **Responsibilities:** The Value-Based finance team is seeking a Financial Analytics Lead . This individual will work across the business, and will be highly ... to support critical business decisions and optimize outcomes. + Lead design and development of Power BI reporting and...to leadership. + Partner with DH&A team to evaluate claims data to drive deeper insights into the business… more
- Sedgwick (Tallahassee, FL)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Finance Team Lead **PRIMARY PURPOSE** **:** To supervise various aspects of the revenue cycle ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more… more
- Prime Therapeutics (Tallahassee, FL)
- …passion and drives every decision we make. **Job Posting Title** Lead Business Analyst-REMOTE/Configuration exp preferred **Job Description Summary** Serves as ... liaison between departmental team business owners, end users, IT, Claims and Clinical departments. Responds to ad hoc requests for support, reports and analysis.… more