- Eisai, Inc (Nutley, NJ)
- At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care ... difference. If this is your profile, we want to hear from you. The Associate Director , Compliance Operations will be a key member of Eisai's US Ethics & Compliance… more
- Merck & Co. (Rahway, NJ)
- …medicines, vaccines and animal health products.- Today, we are building a new kind of healthcare company - one that is ready to help create a healthier future for ... factual and other issues pertaining to mass tort and commercial litigation claims and work closely with business units to properly defend and/or prosecute… more
- Merck & Co. (Rahway, NJ)
- Job Description Role Summary The Associate Director of Procurement for Capital Projects will be responsible for overseeing and managing procurement activities for a ... portfolio of large and complex capital projects. This role includes project procurement planning,...with company policies and processes. - Reporting to the Director of Capital Procurement Project Execution within the Global… more
- Elevance Health (Indianapolis, IN)
- ** Director I Claims ** **Location** : _This...auditing of claim payments. Provides guidance on the most complex claims . **How you will make an ... an accommodation is granted as required by law._ The ** Director I Claims ** is responsible for directing...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… 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
- Providence (OR)
- …approve statements for services and take proper steps to pay vendors * Inform Senior Manager Claims of large or complex claims and claims with potential ... and to assist the SVP Chief Risk Officer, Executive Claims Director , and Senior Manager Claims...Healthcare Risk Management (CPHRM) * 2 years of healthcare professional liability (medical malpractice) claims processing… more
- Molina Healthcare (Orlando, FL)
- **Job Summary** The Program Director , TechOps Core Systems provides department-level oversight for TechOps Core Systems performance and initiatives with emphasis on ... QNXT platform evolution, AI adoption, claims adjudication, provider/benefit configuration, and payments modernization. The role orchestrates cross‑functional… 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
- The Cigna Group (Cleveland, OH)
- …LOCATION: Must reside in the Cleveland or Independence, OH area.** The ** Director ** **,** **Provider Contracting Network Management** serves as an integral member of ... for a local given territory. **DUTIES AND RESPONSIBILITIES** + Manages complex contracting and negotiations for fee for service and value-based reimbursements… more
- GE HealthCare (VA)
- …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
- Waystar (Louisville, KY)
- **ABOUT THIS POSITION** This role reports to a Director , Product Management and work closely with User Experience team and Technology teams. The Sr. Product Manager ... reports, and assessing strengths and weaknesses of competitors + Studying healthcare industry standards and staying up-to-date on industry changes and compliance… more
- Providence (Portland, OR)
- …**Calling all Esteemed Leaders!** Are you a strategic mastermind with a passion for healthcare ? Do you thrive on navigating complex challenges and shaping the ... in Portland, OR Seattle, WA or Irvine, CA. The Director of Payment Integrity (PI) is responsible for overseeing...Finance, or related field. + **Experience:** 5 years in healthcare payment integrity, claims operations, or … more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- … will lead a small team of experienced employee relations experts who together solve complex problems on a regular basis. The Director is expected to stay ... **Job Summary** Otsuka Pharmaceutical Company is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health… more
- Humana (Montgomery, AL)
- … 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 (Raleigh, NC)
- … 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
- Elevance Health (Atlanta, GA)
- …Ability to inspire teams, manage large-scale initiatives, and drive innovation in a complex healthcare ecosystem is preferred.. * Deep understanding of ... ** Director II Engineering** **Location:** This role requires associates...Build and scale cloud-based data platforms integrating RWD, EHR, claims , and other healthcare data. * Partner… more
- LA Care Health Plan (Los Angeles, CA)
- …and complex regulatory landscape facing managed care. The Senior Director , Chief Enterprise Analytics ensures that analytics and decision support are tightly ... Senior Director , Chief Enterprise Analytics Job Category: Management/Executive Department:...and alignment with strategic goals. Proven ability to navigate complex regulatory environments in healthcare , particularly in… more
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