- Citizens (Johnston, RI)
- …for Consumer, Commercial and Business Banking Products. We are seeking a Private Ops Fraud Sr. Manager to provide operational support for all functional areas ... Description Private Operations is committed to delivering a best-in-class experience...with business partner in related functional areas associated with fraud and claims investigations + Identify and… more
- VNS Health (Manhattan, NY)
- …strategies to reduce claim errors and payment delays. + Oversees the day-to-day operations of the claims processing department, ensuring adherence to established ... OverviewOversees the efficient and accurate processing of claims , resolution of payment disputes, and implementation of claims quality improvement initiatives.… more
- AIG (Lenexa, KS)
- …Fraud referrals. + Increased responsibility with an expectation of managing higher claims volumes and assist manager with customer escalations and file audits ... help customers to manage risk. Join us as a Claims Examiner II, Accident & Health to play your...an exciting time to join us - across our operations , we are thinking in new and innovative ways… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- **Job Summary** Senior Manager , GPV Aggregate Report & RMP Operations Apply knowledge and expertise in the area of aggregate reports and risk management plans. ... Deliverables + Reports to the Global Lead of Aggregate Report & RMP Operations + Contributes to the project management for production of Aggregate Safety Reports… more
- Walmart (Douglas, GA)
- …business stakeholders to solve complex business issues (for example, business operations , necessary skills,). Develops business cases for projects with projected ... practices and policies. Lists common tasks and activities performed by operations functions and subfunctions. **Asset Protection & Security** Possesses knowledge of:… more
- Walmart (Chino, CA)
- …business stakeholders to solve complex business issues (for example, business operations , necessary skills,). Develops business cases for projects with projected ... practices and policies. Lists common tasks and activities performed by operations functions and subfunctions. Asset Protection ; Security Possesses knowledge of:… more
- NTT DATA North America (Lincoln, NE)
- …a HC and Insurance Operations Analyst to join our team. **Posisition:** ** Claims Case Manager ** **This position is eligible for company benefits including ... voluntary or legally required benefits.** **Role Overview:** We are seeking a dedicated Claims Case Manager to provide comprehensive claim servicing to our… more
- Otsuka America Pharmaceutical Inc. (Rockville, MD)
- …the Chief Compliance Officer in executing an effective compliance program. The Manager , Healthcare Law Auditing & Monitoring, executes the annual plan by conducting ... healthcare laws, regulations and guidance (such as the Anti-Kickback Statute, False Claims Act, OIG Guidance for Pharmaceutical Manufacturers, PhRMA Code, FDCA and… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- The Manager will report to the Associate Director, Transparency & Aggregate Spend, GRC and will oversee and ensure OAPI and OPDC compliance with state financial ... as needed, to the Associate Director, compliance analytics and operations . This role is responsible for the accurate preparation,...Ability to meet deadlines with minimal supervision, as a manager as well as a team member + Proven… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- The Sr. Manager , CTA Regulatory Strategy is responsible for providing critical support in developing global regulatory strategy, planning, and execution of global ... Lead (GRL). + As an integral member of Otsuka's Regulatory Operations team, provides support for regulatory strategy assignments, monitoring, and oversight,… more
- Walmart (Sequim, WA)
- …training needs and developing and delivering the training where needed Manages claims and receiving operations by ensuring proper policies and procedures ... violations of company policies and criminal activities by investigating alleged fraud and other alleged illegal activities conducting investigations relating to the… more
- AAA Mid Atlantic (Wilmington, DE)
- …in place. + Assists with investigations into Workers Compensation and general liability claims , vehicle accidents and fraud with Corporate Legal, Internal Audit, ... Club Alliance (ACA) is hiring for a Director, Facilities Operations to join our team! What We Offer You:...+ Establishes, implements, and monitors incident response to theft, fraud , and other criminal behaviour. Provide guidance to the… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …regulatory team (GRL, regional leads, CMC-RA, labeling, medical writing, regulatory operations , etc.) to develop global regulatory plans, address global regulatory ... contacting Accommodation Request (EEAccommodations@otsuka-us.com) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of… more
- LifePoint Health (Richlands, VA)
- …review, in conjunction with the Operations Team, when applicable. * Notifies Operations Team, Risk Manager and the companies Legal Counsel of potential ... and safety regulations. Is a liaison to the Risk Manager /Coordinator, facilities legal team and out-side agencies to mitigate...fraud or theft * In coordination with the Operations Team, may be asked to conduct on-going patient… more
- Eastern Bank (Lynn, MA)
- …the Enterprise Risk Management Division and reports to the VP Security Manager . AVP, Security Investigator III is responsible for the initiation, investigation and ... of diverse and complex investigations both internal and external, to determine fraud exposure to the bank. Utilizing multiple systems, tools and investigative… more
- AmeriHealth Caritas (Newtown Square, PA)
- …will work cross-functionally to create and develop creative proactive approaches to mitigating fraud . The Manager , SIU Data & Analytics oversees a team of ... or enhances a working knowledge of Managed Care Activities: Member Services, Operations Services, Claims , Provider Relations, Finance and any other functional… more
- Bausch Health (Bridgewater, NJ)
- …Access Analytics within Bausch Health's Commercial Insights, Analytics & Operations department. Responsibilities: + Provides market insights across all therapeutic ... areas by utilizing knowledge of the Market Access landscape, PlanTrak data, Patient Claims data, and Formulary data. + Conducts analytics in Market Access space… more
- Staples (London, OH)
- …and programs in Supply Chain locations related to inventory loss, theft, and fraud . + Ensures appropriate internal risk controls are in place through the application ... strategies. + Manage workplace violence mitigation programs. + Manages the WC claims process, in the field, and ensures compliance to the Return-to-Work efforts.… more
- VNS Health (Manhattan, NY)
- …reimbursement, CEU credits, and advancement opportunities What You Will Do + Assists the Manager in analyzing and validating managed care claims and comp grids ... Plans pays our Providers appropriately and contains cost. + Investigates utilization and claims coding patterns to identify potential fraud , waste or abuse and… more
- Pegasystems (Boston, MA)
- …AI capabilities for financial services use cases such as intelligent underwriting, claims processing, fraud detection, and personalized customer journeys + ... Senior Manager of Solutions Consulting - Financial Services Job...meet their strategic business goals by streamlining their critical operations to engage their customers across multiple channels using… more
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