- R1 RCM (Boise, ID)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Claims Processing Operations Lead ,** you will ... providing solutions for internal teams. **Here's what you will experience working as a Claims Processing Operations Lead :** + Lead team meetings and… more
- Cognizant (Boise, ID)
- …is a work-from-home position with day shifts and no travel required. **Responsibilities** + Lead and oversee the daily operations of the team to ensure efficient ... **Team Lead Configuration Healthcare** This position is Hybrid. **Job...candidate will have mandatory technical skills in Facets - Claims and Facets with a preference for domain experience… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …Efficiency and Process Improvement** + Identify opportunities for process improvement and lead initiatives to streamline GMA operations worldwide + Implement and ... an exceptional Associate Director of Global Medical Affairs (GMA) Excellence & Operations to support our emerging rare disease portfolio, following our recent… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …for Pharmacovigilance Aggregate Reporting and Risk Management Deliverables + Reports to the Global Lead of Aggregate Report & RMP Operations + Contributes to the ... **Job Summary** Senior Manager, GPV Aggregate Report & RMP Operations Apply knowledge and expertise in the area of...the area of aggregate reports and risk management plans. Lead project management activities for Aggregate Reports, Risk Management… more
- CVS Health (Boise, ID)
- …across the organization. + Collaborates with various departments, such as Core Operations - Claims , Plan Build, Eligibility, Appeals, Compliance and Client ... we do it all with heart, each and every day. **Position Summary:** The Lead Director is responsible for leading and optimizing Quality Operations , including all… more
- Trinity Health (Boise, ID)
- …SMDA tracking and/or reporting. **Liability Claims Support** + Works with liability claims staff to coordinate the investigation, processing , and defense of ... identifies improvement opportunities for near misses and adverse events. Supports claims management activities related to incidents and litigated cases. Responsible… more
- Molina Healthcare (Meridian, ID)
- …healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare data, including ... and manage information from large data sources + Analyze claims and other data sources to identify early signs...and investigate complex suspect areas regarding UM and CM operations and their impact on medical cost, initiate in-depth… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …**(PK)** , **Pharmacokinetics-Pharmacodynamics (PK/PD)** and regulatory submissions. You will lead study design, execution and reporting of **clinical pharmacology** ... early development and business development team members and external collaborators to assess/ lead development and selection of pre-IND and early phase assets. **Job… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …for assigned Clinical Trial Application projects in alignment with the Global Regulatory Lead (GRL). + As an integral member of Otsuka's Regulatory Operations ... strategy assignments, monitoring, and oversight, as well as a lead or support of GRA efforts + Ensures assigned...regulatory obligations + Acts as primary liaison between Regulatory Operations and Clinical Management as well as other multiple… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …activities for all assigned projects in alignment with the Global Regulatory Lead . Translates complex pertinent global requirements and provides an assessment of the ... and manages lifecycle regulatory activities in alignment with the Global Regulatory Lead (GRL). - Identifies the need and obtains regulatory intelligence, researches… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …all affiliates are inspection ready, oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain ... readiness across all clinical trial sites, clinical and Pharmacovigilance (PV) operations . + **Audit Management:** Oversee the planning, execution, and follow-up of… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …Specialists to plan and execute publication activity. **Job Description** + Lead the Strategic Publication Planning Group (SPPG) meetings for assigned compound(s) ... analyses, and global newsletters + Collaborate with Global Medical Operations and Communications leads and others to plan and...in support of key data and scientific presence + Lead and contribute to internal communications regarding pre- and… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …Overview** Reporting to the Senior Director of Medical Affairs Excellence & Operations , this role will orchestrate Otsuka's presence at major medical congresses, ... Otsuka's pipeline and product lifecycle stages + Create and lead the Congress Steering Committee in partnership with key...offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
- Molina Healthcare (Meridian, ID)
- …healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
- Prime Therapeutics (Boise, ID)
- …confrontational situations + Knowledge and understanding of pharmacy or medical claims processing environment **Preferred Qualifications** + Certified Fraud ... and client initiatives; engage in cross functional analysis of medical and pharmacy claims ; lead FWA investigations for federal employee program + Stay current… more
- Public Consulting Group (Boise, ID)
- …+ Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + ... (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and...key member of the executive team, the CIO will lead the Practice Area's tech vision, ensuring that the… more
- Cardinal Health (Boise, ID)
- …preferred + Knowledge of the specialty drug product marketplace, health insurance claims processing , and commercialization of products and working with pharma ... and Patient Support (APS) is responsible for the tactical execution of operations of assigned program(s) for contracted client manufacturer(s). This individual will… more
- Cardinal Health (Boise, ID)
- …of data to create innovative solutions that improve patient outcomes, streamline operations , and enhance the overall healthcare experience. We are seeking a highly ... Difference: Contribute to cutting-edge solutions that improve patient care, enhance healthcare operations , and drive positive change in the industry. + Work with a… more
- Cognizant (Boise, ID)
- …use Optum PPS configuration. + Demonstrate strong understanding of healthcare claims processing , provider contracts, fee schedules, and benefits configuration. ... participation. **Key Responsibilities:** + Conduct requirements discovery sessions and lead design sessions to determine the best configuration of...+ Knowledge of health plan operations for Medicare, Medicaid, Marketplace, LTSS, DSNP (duals) is… more