• Claims Complex Director

    AIG (San Francisco, CA)
    Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within ... an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability...+ 7+ years of medical malpractice / professional liability complex claims and/or complex litigation… more
    AIG (03/04/25)
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  • Director , Health Claims

    System One (Newtown Square, PA)
    …experience in high-volume claims environments. + Extensive knowledge of healthcare claims processing, adjudication, and compliance. + Demonstrated success in ... Job Title: Director , Health Claims Administration Location: Newtown...today for immediate consideration! Responsibilities + Deep understanding of healthcare regulations, claims adjudication, and compliance (HIPAA,… more
    System One (04/19/25)
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  • Risk and Claims Specialist

    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
    Billings Clinic (03/28/25)
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  • CRT Claims Examiner

    Integra Partners (Troy, MI)
    …dynamic, proven Claims Examiner, with a specific background in the complex rehab technology (CRT) space. This role is responsible for real time support ... that exemplifies high energy and a passion for the healthcare business. To succeed, the individual will need to...Duties + Be prepared to appeal or correct CRT claims in compliance with Medicare, Medicaid, and commercial insurance… more
    Integra Partners (02/13/25)
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  • Managed Care Claims Validator / Biller

    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
    CommuniCare Health Services Corporate (04/28/25)
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  • Corporate Director , PFS Outsourcing…

    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
    Prime Healthcare (03/21/25)
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  • Director of Policy & Legal/…

    City of New York (New York, NY)
    Director of OHSSA. This position will also serve as the inaugural Director of Healthcare Accountability, leading strategy and implementation for Local Law ... the Agency's Chief Medical Officer. The BEHS is the healthcare systems bureau of DOHMH. Our mission is to...routinely update their interpretation in accordance with a highly complex , rapidly evolving regulatory environment. - Stay informed of… more
    City of New York (02/12/25)
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  • Director , Actuarial Services - Transform…

    Evolent (Columbus, OH)
    …support value-based healthcare across all lines of business, particularly in complex conditions such as oncology and cardiology. We are advocates for creating ... humility, adaptability, intellectual curiosity, and accountability as we solve complex business problems. **Collaboration Opportunities:** The Director ,… more
    Evolent (03/22/25)
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  • Senior Director , Client Partner Executive…

    Conduent (Florham Park, NJ)
    …of a culture where individuality is noticed and valued every day. **Senior Director , Client Partner Executive - Healthcare ** **Are you an accomplished Client ... large enterprise accounts?** **About the Role** As a Senior Director , Client Partner Executive at Conduent, you will lead...on Conduent's full suite of BPO services in the healthcare sector, including: + Claims processing +… more
    Conduent (04/10/25)
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  • Corporate Director of Clinical Utilization…

    Prime Healthcare (Ontario, CA)
    …including Claims and Customer Service, to provide guidance on complex Authorizations, Referrals, Denials and Appeals. + Integrates and coordinates services using ... and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical-utilization-management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management… more
    Prime Healthcare (04/17/25)
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  • Director of Design and Construction

    Bassett Healthcare (Cooperstown, NY)
    …experience in design and construction with at least 10 years in a healthcare setting, required Proven leadership in managing complex hospital projects, required ... health and enjoy the best quality of life possible. What you'll do The Director of Design & Construction will lead all design, planning, and construction for all… more
    Bassett Healthcare (04/30/25)
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  • Global Medical Director , Evidence…

    Sanofi Group (Morristown, NJ)
    **Job title** : Global Medical Director , Evidence Generation - Insights and Strategy **Location:** Cambridge, MA, Morristown, NJ **About the Job** Sanofi's ambition ... best in class therapeutic solutions that address highest unmet needs. The Director for Medical Evidence Innovation in the Next-Gen Immunology franchise will serve… more
    Sanofi Group (05/02/25)
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  • Sr. 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 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
    Waystar (04/25/25)
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  • Director , Network Strategy (Marketplace)…

    Molina Healthcare (Columbus, OH)
    …with federal and state laws. Negotiates and services larger and more complex market/national/group-based providers in accordance with company standards in order to ... expectations * Evaluates, negotiates and supports larger and more complex market/national/group-based providers in compliance with company standards while meeting… more
    Molina Healthcare (04/13/25)
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  • Lead Director , Healthcare Insurance…

    CVS Health (Tallahassee, FL)
    …will do** **:** . Leads five different functional areas within Meritain, claims adjustments, recovery, FSA administration, front end mail, and data administration ... Minimum Requirements** **:** . Minimum 10 years work experience in healthcare insurance operations and/or customer service providing strong member experiences. .… more
    CVS Health (04/27/25)
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  • Director - Hospital Billing - Mount Sinai…

    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
    Mount Sinai Health System (03/29/25)
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  • Director Global Strategic Marketing…

    J&J Family of Companies (Irvine, CA)
    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
    J&J Family of Companies (04/30/25)
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  • Director , Digital Health Corporate Counsel

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …Founded on Otsuka's rich history in delivering breakthrough innovations to solve complex problems for patients, Otsuka Precision Health (OPH) is the next step ... transform the health experience, one connection at a time, together. The ** Director , Digital Health Corporate Counsel** will be responsible for providing legal… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Medicaid N. Central

    Humana (Columbus, OH)
    … 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
    Humana (04/24/25)
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  • Medical Director - Care Plus - Florida

    Humana (Columbus, OH)
    … 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 (04/24/25)
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