- Sedgwick (Madison, WI)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for ... managing SIU investigations of complex fraud schemes involving providers, vendors, attorneys and others;...degree from an accredited college or university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI),… more
- Humana (Madison, WI)
- …understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …Founded on Otsuka's rich history in delivering breakthrough innovations to solve complex problems for patients, Otsuka Precision Health (OPH) is the next step ... health experience, one connection at a time, together. The ** Director , Digital Health Corporate Counsel** will be responsible for...with other members of the OPH Legal team on complex matters and matters of first impression, as well… more
- Evolent (Madison, WI)
- …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected… more
- Humana (Madison, WI)
- … 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
- American Family Insurance - Corporate (Madison, WI)
- …Requirements + Demonstrated effective leadership skills. + Demonstrated experience communicating complex claims litigation concepts to business clients in a ... a team of litigation management professionals who manage a portfolio of litigated claims . Executes legal and claims litigation strategy objectives adhering to… more
- Humana (Madison, WI)
- … 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
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- ** Director , Medical Affairs Congress Strategy and Execution** The Director , Medical Affairs Congress Strategy and Execution, plays a pivotal role in Otsuka's ... elevate our overall GMA objectives. **Position Overview** Reporting to the Senior Director of Medical Affairs Excellence & Operations, this role will orchestrate… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …for the maintenance of everyday health** **As the** **Associate Director ,** **Statistical** **Programming** **, you will** **be** **responsible for** **managing** ... **managing** **and develop** **ing** **programmers.** **This position reports to the Director of Statistical Programming and can be based in Rockville, Maryland… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- The Associate Director , TLL, Renal Rare Disease, is a field-based, customer facing, non-sales position on Otsuka's Rare Renal team focused on enhancing and improving ... present and educate/present to KOLs and customer groups on complex and scientific/clinical information. + Assess and understand KOL...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Evolent (Madison, WI)
- …health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek ... insights. We value curiosity, creativity, and independence, working collaboratively to solve complex challenges and enhance the impact of our specialty programs and… more
- Evolent (Madison, WI)
- …humility, adaptability, intellectual curiosity, and accountability as we solve complex business problems. **Collaboration Opportunities:** The Director , ... health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- The Director , Global Medical Publications will support Otsuka in leading and developing an overall scientific communication strategy for publications and congresses, ... messages succinctly + Understand detailed technical information and convey complex ideas to a variety of audience types and...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Lincoln Financial (Madison, WI)
- …#:** 74514 **The Role at a Glance** We are excited to bring on a Clinical Director to our claim's organization. This role will be remote, or hybrid based on the ... proximity to Charlotte or Omaha. As a Clinical Director , you will provide leadership and direction to drive...and provide direction on all aspects of various assigned complex transformational projects within the clinical organization, with a… more
- Humana (Madison, WI)
- …Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness and… more
- Cardinal Health (Madison, WI)
- …can get life-changing therapies to patients who need them-faster. The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Humana (Madison, WI)
- …The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Highmark Health (Madison, WI)
- **Company :** enGen **Job Description :** **JOB SUMMARY** The Director of Sales & Partnerships is a critical leadership role responsible for driving significant ... as well as outsourced technology and BPO services. The Director is a strategic thinker with experience in selling...of SaaS, PaaS, BPaaS and professional services in a complex healthcare sales cycle environment + 8 years of… more
- Sedgwick (Madison, WI)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Finance **PRIMARY PURPOSE** **:** To direct all aspects associated with ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Evolent (Madison, WI)
- …health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek ... for the mission. Stay for the culture. **What You'll Be Doing:** The Director of Performance Analytics - **Oncology and Member** focus leverages and creates analytic… more