• Claims Manager - Liability - REMOTE

    Ryder System (Salt Lake City, UT)
    …of assigned staff. Assists Director with other staff as directed. Work with Director and other management team to develop tactics and strategies to achieve ... staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues....annual metrics and other KPI's + Participates with the Director in the selection and management of… more
    Ryder System (02/25/25)
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  • Product Manager - Claims Management

    Waystar (Lehi, UT)
    **ABOUT THIS POSITION** This role reports to a Director , Product Management and work closely with User Experience team and Technology teams. The Product Manager ... and product quality + Assisting your VP of Product Management in coordinating with sales, marketing, development, and customer...+ bonus, if applicable) + Customizable benefits package (3 medical plans with Health Saving Account company match) +… more
    Waystar (03/17/25)
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  • Medical Director - Medicaid N.…

    Humana (Salt Lake City, UT)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (03/11/25)
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  • Medical Director - Care Plus…

    Humana (Salt Lake City, UT)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (03/18/25)
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  • Medical Director - National Medicare…

    Humana (Salt Lake City, UT)
    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 (03/11/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Provo, UT)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (02/06/25)
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  • Hematology Regional Medical Scientific…

    Merck (Salt Lake City, UT)
    **Job Description** The Hematology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, or PharmD) therapeutic and disease expert who ... engages in scientific exchange with leaders in the external medical and scientific community. Scientific exchange does not include promotional claims about any… more
    Merck (03/04/25)
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  • Senior Director of Underwriting - REMOTE

    Prime Therapeutics (Salt Lake City, UT)
    …our passion and drives every decision we make. **Job Posting Title** Senior Director of Underwriting - REMOTE **Job Description** The Sr. Director Underwriting ... for prospective clients and new customer acquisitions. **Responsibilities** + Analyze claims data and develop cost-of-care projections for existing customer renewals… more
    Prime Therapeutics (03/11/25)
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  • Director , Special Investigations Unit,…

    Molina Healthcare (Provo, UT)
    …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... from root cause analysis through implementation * Oversees vendor FWA case management including tracking on schemes, coordinating internal efforts with vendor to… more
    Molina Healthcare (03/15/25)
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  • Executive Director , Strategic Partnerships

    Trustmark (Salt Lake City, UT)
    …+ Collaborate with the sales leadership teams of VP of Sales & Client Management , Senior Directors' Sales, and the whole sales team to maximize opportunities. + ... accounting of activities and sales. + Collaborate with and support the Client Management team to assure persistency goals are being achieved. + Review national… more
    Trustmark (02/19/25)
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  • Case Management Specialist

    University of Utah Health (Salt Lake City, UT)
    … departmental goals. + Internal resources include but not limited to: case management medical director , nursing staff, social services, compliance, risk ... It utilizes skills and knowledge as a subject matter expert to guide case management and facility staff to improve patient care within these populations and to… more
    University of Utah Health (03/13/25)
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  • Information Coordinator - Behavioral Health…

    University of Utah Health (Salt Lake City, UT)
    …and 25+ facilities across Utah. This coordinator role will work with reports/ claims data, assist with appeals and grievances, and ideally requires experience with ... health plans and claims . Additionally, the coordinator will support and collaborate closely...and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. **Responsibilities** + Provides… more
    University of Utah Health (02/21/25)
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  • EHS and Risk Manager

    Admiral Beverage Corporation (Salt Lake City, UT)
    …safety, distribution, or fleet experience or related professional experience in managing claims for multi-lines and risk management with a proven track ... Workday Account. Job Description Primary Location: Salt Lake City, Utah Corp Safety Director : This position is responsible for supporting the company in the … more
    Admiral Beverage Corporation (02/04/25)
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  • Manager, Provider Contracts

    Molina Healthcare (Provo, UT)
    …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * In conjunction with the … more
    Molina Healthcare (03/04/25)
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  • Prior Authorization Rep II

    University of Utah (Salt Lake City, UT)
    …or denied authorization requests, escalate for resolution. 4. Facilitates provider and insurance medical director 's reviews for medical determination if the ... of U Health - Academics **Department** 00209 - Univ Medical Billing - Oper **Location** Other **City** Other **Type...records are submitted in the authorization request. 7. Resolve claims denials related to the prior authorization, as needed.… more
    University of Utah (02/21/25)
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  • Manager-Performance Strategy (Amex Assurance)

    American Express (Sandy, UT)
    …related change management efforts. The manager will report to the Director of Partner Management and Operations Strategy. **Responsibilities:** + Work with ... as our proprietary teams. Additionally, the team is responsible for the management and regulatory aspects of Amex's wholly owned subsidiary, Amex Assurance Company.… more
    American Express (03/12/25)
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  • PS Patient Financial Advocate

    University of Utah (Salt Lake City, UT)
    …managers/case workers, and patients, regarding the status of funding. Works with Medical Director , physicians, and billing offices to determine cost estimates ... Seldom: Bending, reaching overhead. **Minimum Qualifications** Four years experience with medical accounts receivable, insurance claims , or equivalency (one year… more
    University of Utah (02/04/25)
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  • Senior Analyst - Client Audit

    CVS Health (Salt Lake City, UT)
    …team in an Sr. Analyst role. This is a client facing project management / auditor position that is responsible for coordinating, managing, tracking, reviewing, ... of exceptions identified during the audit process, specifically related to pharmacy claims and manufacturer rebates. This includes having a working knowledge base… more
    CVS Health (03/14/25)
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  • Outpatient/Provider Coder II

    University of Utah Health (Salt Lake City, UT)
    …billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding. This ... and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. **Responsibilities** + Reconciles clinic… more
    University of Utah Health (03/05/25)
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  • Regulatory Compliance Specialist

    University of Utah (Salt Lake City, UT)
    …will utilize coding knowledge to abstract, record and audit data from medical records. Provides support to areas related to documentation, regulatory education and ... auditing. **Responsibilities** 1. Locates and compiles required medical documentation from a variety of different sources, ensuring completeness and accuracy in… more
    University of Utah (02/18/25)
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