- Premera Blue Cross (Mountlake Terrace, WA)
- … Operations Director ** to join our team and oversee our claims management organization. This position offers an exceptional opportunity to contribute ... expertise will play a crucial role in enhancing the quality and efficiency of our claims processes. In this capacity, you will lead a strong claims team, drive… more
- Ryder System (Olympia, WA)
- …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
- Humana (Olympia, WA)
- …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 (Olympia, WA)
- …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 (Olympia, WA)
- … 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
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a Director Clinical Risk Management In this role you will oversee and administer the risk management activities for ... a working director for the assigned network. Handles day-to-day risk management operations and tasks including on call coverage, position vacancy support and… more
- Centene Corporation (Olympia, WA)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Molina Healthcare (Tacoma, WA)
- …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
- Premera Blue Cross (Mountlake Terrace, WA)
- …our Healthsource blog: https://healthsource.premera.com/ . We are seeking a talented ** Director , Enterprise Risk Management ** to direct and provide oversight ... Advise and support the Chair of the Enterprise Risk Management Committee in Enterprise Risk Management (ERM)...coverage working with broker. Direct the administration of insurance claims to ensure timely and accurate reporting, analysis, and… more
- Centene Corporation (Olympia, WA)
- …Medical Director to direct and coordinate the behavioral health medical management , quality improvement and credentialing functions for the business unit. ... everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization… more
- EPAM Systems (Seattle, WA)
- …driving strategic and operational excellence across client functions such as underwriting, claims and distribution management . You will contribute to the ... - go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit,… more
- The Cigna Group (Seattle, WA)
- …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical ... The ** Director , Provider Contracting** serves as an integral member...This role assists in developing the strategic direction and management of the day to day contracting and network… more
- WSP USA (Seattle, WA)
- This Opportunity WSP has a career opportunity for a **Senior Technical Director , Contract Manager** . This role will be responsible for post-award contract ... management working within WSP on behalf of our Clients,...Client's organization. + Change order negotiations and execution + Claims analysis and negotiation. + Manage and resolve any… more
- Molina Healthcare (Seattle, WA)
- …* 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
- Trustmark (Olympia, WA)
- …+ 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
- Swedish Health Services (Seattle, WA)
- …analyzed, and controlled by overseeing selected programs + **Incident & Claims Management :** Investigate incidents, implement loss control and mitigation ... In this role, you will work closely with the Director of Risk Management to plan, direct,...+ Working in a medico-legal environment with understanding of claims management principles + Working experience coaching… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …liability risk transfer mechanisms in partnership with the ERM (Enterprise Risk Management ) Director , ERM Executive Committee, and commercial insurance brokers. ... field or 4 years equivalent experience (Required) + 4 years of analytical, risk management , claims , or related experience (Required) + Have or are willing to… more
- University of Washington (Seattle, WA)
- …all University-wide risk management functions, including: + Compliance Services + Risk Management + Claims Services + Risk Financing & Consulting + Office of ... gender identity or expression; disability; and veteran status across all UW campuses, medical centers & clinics, and anywhere the UW does business or provides… more
- Molina Healthcare (WA)
- …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
- UMB Bank (Olympia, WA)
- …across all payment channels. Will work with the Enterprise Fraud Prevention and Claims teams to provide data to help identify emerging fraud trends and UMB's ... concert with the Enterprise Fraud Prevention and Enterprise Fraud Claims teams to identify fraud exposure and make necessary...to fulfill overall business needs and expectations of the Director of Enterprise Fraud Operations and the bank's senior… more