- Parexel (Washington, DC)
- **Project Lead ,** **Meeting Services** We are looking for a Meeting Specialist to join our talented and supportive team of 40+ delivering high quality ... for your clients as you look after projects end-to-end working with a team of likeminded individuals. Qualities such as being highly self-motivated, driven, and… more
- Sedgwick (Washington, DC)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance ( Remote ) Claims Team Lead - Workers Compensation | AZ, ... activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on ...Excellent negotiation skills + Ability to work in a team environment + Ability to meet or exceed Performance… more
- Sedgwick (Alexandria, VA)
- …Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead | VA Jurisdiction | Remote **Are you looking for an opportunity to ... and negotiate settlements; and to provide backup for team lead when out of the office....of education and experience required. 2 years of supervising claims team . + High School Diploma or… more
- Citizens (Washington, DC)
- Description Product Owner, Claims Management Platform & Transformation Lead We are seeking a results-driven leader to own and drive the development and ... transformation of our Claims Management product platform and its evolution toward next-generation...hybrid schedule of four days onsite and one day remote per week: + Johnston, RI - One Citizens… more
- Humana (Washington, DC)
- …some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, and Humana colleagues. After completion of mentored ... adapt and the courage to innovate **Additional Information** Typically reports to a Lead Medical Director, depending on the line of business. The Medical Director… more
- Humana (Washington, DC)
- …healthcare operations, or insurance industry, with at least 1 year in a supervisory or team lead role. **Knowledge & Skills:** + Solid understanding of claims ... a part of our caring community and help us put health first** The Supervisor, Claims Review makes appropriate claim decision based on strong knowledge of claims … more
- Carrington (Washington, DC)
- **Come join our amazing team and work remote from home!** The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring the proper incurred ... to reduce costs and eliminate non-essential and manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including,… more
- Cognizant (Washington, DC)
- **Product Consultant - Facets Claims & Payer Domain** **Work Model: Remote ** **Employment Type: Full-Time** **Job ID: 00066023611** **About the role** As a ... You will be a valued member of the delivery team and work collaboratively with stakeholders across business and...payer domain systems. **In this role, you will:** + Lead the implementation and customization of Facets Claims… more
- Prime Therapeutics (Washington, DC)
- …drives every decision we make. **Job Posting Title** Pricing Analyst Senior - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of ... of new or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses and provide consultation and analytic insight… more
- Prime Therapeutics (Washington, DC)
- …Experience with data consolidation and modeling **Preferred Qualifications** + Team lead /supervisory/management experience + Business Intelligence consulting ... drives every decision we make. **Job Posting Title** Reporting Principal - Remote **Job Description** The Finance Reporting Principal is responsible for supporting… more
- Prime Therapeutics (Washington, DC)
- …pharmacy with us. **Job Posting Title** Principal Solution Strategist - JUDI - Remote **Job Description** **We are currently on the lookout for a Principal Solution ... Strategist to help lead the Medicare and Medicaid migrations for the JUDI...products + Experience using queries, thorough understanding of pharmaceutical claims data and general understanding of medical claims… more
- Prime Therapeutics (Washington, DC)
- …pharmacy with us. **Job Posting Title** Manager Reporting & Analytics - Remote **Job Description** The Manager Reporting and Analytics is responsible for developing ... to scope, quality, efficiency, budget, schedule and benefit. **Responsibilities** + Lead the development of the department reporting strategy based on compliance… more
- Prime Therapeutics (Washington, DC)
- …drives every decision we make. **Job Posting Title** Sr Solution Strategist - Remote **Job Description** **Calling all Solution Strategists! We are looking for a ... Solutions Strategist to be a part of our JUDI Team . If you are interested in working within a...utilized to provide recommendations on product discovery and definition, lead estimation efforts and delivery at performance review sessions… more
- CareFirst (Baltimore, MD)
- …reside in the CareFirst service area)** **PURPOSE:** This role will lead , guide, strategize and manage negotiations for provider-specific institutional, ancillary, ... company policies and procedures, and coordinating with the Payment Transformation team to transition fee-for-service arrangements to value-based care. This role will… more
- Prime Therapeutics (Washington, DC)
- …Posting Title** Sr. Solution Strategist - Benefit Configuration - JUDI - Remote **Job Description** **The Senior Solution Strategist - Benefit Configuration** is ... presentations utilized to provide recommendations on product discovery and definition, lead estimation efforts and delivery at performance review sessions + Create,… more
- CareFirst (Baltimore, MD)
- …is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** **Education Level:** High ... capture and proper use of CPT, HCPCS, and ICD 10 codes in claims submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting… more
- Prime Therapeutics (Washington, DC)
- …every decision we make. **Job Posting Title** Health Plan Account Manager Sr - Remote **Job Description** The Sr Health Plan Account Manager serves as a line of ... clients, account leaders and internal partners to fulfill client commitments, lead client communications, coordinate product presentations and adoption, and champion… more
- Prime Therapeutics (Washington, DC)
- …non-lawyer and lawyer professionals and is a key member of the legal department's leadership team . **Responsibilities** + Lead and mentor a team of attorneys ... make. **Job Posting Title** Deputy General Counsel, Litigation - REMOTE **Job Description** The Deputy General Counsel Litigation leads...and regulations such as HIPAA, Anti-Kickback Statute, and False Claims Act, with a focus on PBM and managed… more
- CareFirst (Baltimore, MD)
- …is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** **Education Level:** Bachelor's ... integration, configuration, and performance of core payer functions like enrollment, claims , billing, and customer service. Focuses on building robust custom… more
- CareFirst (Baltimore, MD)
- …expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** **Education Level:** Associate's ... documents coding observations or discrepancies and provides information to management team to further enhance quality and/or provider education. Work with leadership… more
