- Billings Clinic (Billings, MT)
- …regional affiliate locations to support risk functions as indicated by Risk Management Director . The Risk and Claims Specialist assists in coordination of the ... claims at the direction of the Risk Management Director and/or the Risk and Claims Coordinator...Risk & Claims Coordinator and Risk and Claims Analyst on complex issues. * Works… more
- Commonwealth Care Alliance (Boston, MA)
- …billing-related certifications **Required Experience (must have):** + 3+ years in healthcare claims processing, provider reimbursement, or payment integrity. + ... states will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr.… more
- CommuniCare Health Services Corporate (Charleston, WV)
- …leader in post-acute care for those that are chronically ill or have complex conditions. Our more than 150 skilled nursing, assisted living, independent living, ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...team, CBO cash posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management, and others. The… more
- AdventHealth (Altamonte Springs, FL)
- …as assigned. + **The value you'll bring to the team:** + Manages complex professional and general liability claims in multiple jurisdictions which could ... is responsible for the management of assigned potential compensable claims , asserted claims and suits. Management encompasses...require travel to healthcare facilities, depositions, mediations and trials. + Manages the… more
- Prime Healthcare (Farmers Branch, TX)
- …trends and identify opportunities for process improvement and reimbursement optimization. + Complex Claims Management: identifies, trends, and owns portfolios of ... Outsourcing program across Revenue Cycle Management for all Prime Healthcare . The Corporate Director is responsible for... complex claims , including Third party claims , TDRG, Zero… more
- CVS Health (Woonsocket, RI)
- …and key performance metrics for reconciliation, revenue cycle, and adjudication/ claims processes analysis. Facilitate effective solutions related to adjudication and ... processing of pharmacy and vaccine/medical claims , maintaining current services, support optimalization of existing vendor product portfolio, provide continual… more
- Select Medical (Camp Hill, PA)
- …This position will also be involved in special projects as assigned by the Director of CBO or VP Patient Accounting. **Responsibilities** + Trains new IP CBO team ... Leadership and all IP team members. + Any additional projects as assigned by the Director of CBO or VP Patient Accounting + Training on various **OnBase, and old… more
- Norstella (Denver, CO)
- Sr. Director , RWD Analytics and Innovation ( Healthcare & Life Sciences) Company: Norstella Location: Remote, United States Date Posted: Jul 30, 2025 Employment ... India. **Job Description :** We are seeking a dynamic and visionary Senior Director of RWD (Real-World Data) Analytics and Innovation to lead real-world data special… more
- Elevance Health (Norfolk, VA)
- …senior management and prior leadership experience preferred. + Finance experience in a complex healthcare business, with complex data, such as Specialty ... **Be Part of an Extraordinary Team** **Finance Director - Paragon Healthcare ** _A proud...and reporting experience with large data sets such as claims data, drug therapy data, profitability analysis, gross margin… more
- Munson Healthcare (Traverse City, MI)
- … HEALTHCARE 'S OCCUPATIONAL HEALTH TEAM! Full-Time | Monday-Friday | No Call Munson Healthcare is seeking a Medical Director for Occupational Medicine to lead ... injury/illness care, follow-up, and referral. Provide case management support for complex /long-term claims . + Provide leadership, direction and coordination of… more
- Hartford HealthCare (Hartford, CT)
- …And this is*your moment*. **Job:** **Management / Administration* **Organization:** **Hartford HealthCare Corp.* **Title:** *Senior Director of Insurance & Risk ... Work where*every moment*matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in...and Tallwood Urology & Kidney. Position Summary: The Senior Director of Insurance & Risk Financing will establish a… more
- GE HealthCare (NY)
- …acumen are required to achieve outcomes. **Job Description** The Market Service Director will be responsible for developing and executing on strategies to increase ... as ensuring excellent delivery and implementation of contracts, warranty claims , repair/service agreements, spare parts sales, training, installation support, field… more
- Kyndryl (Atlanta, GA)
- …a key leadership role across multi-disciplinary teams, guiding them through complex consulting engagements and be responsible for creating and positioning strategic ... Kyndryl's largest accounts across the C-suite, spanning the intersection between complex Business and IT customer solutions, transformations that impact across the… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Director of Contract Compliance will oversee the contract compliance program, ensuring the organization's contracts, specifically related to ... healthcare billing (hospital and professional), adhere to internal policies,...contract compliance monitoring, risk identification, and issue resolution. The Director will collaborate with various internal departments, including legal,… more
- Humana (Montpelier, VT)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Humana (Salem, OR)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to … more
- J&J Family of Companies (Titusville, NJ)
- At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, ... we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact… more
- Humana (Bismarck, ND)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Community Health Systems (Naples, FL)
- The **System Director of Risk Management** is a key leader responsible for overseeing risk management, patient safety, and regulatory compliance across Physicians ... Regional Healthcare System. This role ensures compliance with federal, state,...collaborate with one to support quality and safety initiatives. ** Claims & Litigation Management** + Oversee legal claims… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- **Job Summary** The Associate Director of Commercial Data Science, CNS, will play a pivotal role in driving data-driven decision making to enhance marketing strategy ... and brand performance. The Associate Director will work closely with cross-functional teams, including Marketing, Commercial Operations and Market Access, to ensure… more