- SaVida Health (Nashville, TN)
- DIRECTOR OF BILLING AND MANAGED SERVICES ABOUT THE ORGANIZATION SaVida Health, a private equity backed healthcare company, provides outpatient opiate and alcohol ... the needs of patients suffering from opiate and alcohol addiction. Summary: The Director of Revenue Cycle Operations is responsible for overseeing all functions of… more
- iCare Health Solutions Enterprise (Miami, FL)
- …agreements across commercial and government programs. Responsible for the accurate configuration and maintenance of contracts in the NextGen Contract Utility, ... and capitation terms Audit contracts to ensure alignment between system configuration and written agreements, including validation of payment terms, effective dates,… more
- Commonwealth Care Alliance (Boston, MA)
- …states will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. ... the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... small to large Operations Management + Collaborate system and data configuration into CES ( Claims Editing System) with BPaaS vendor and other PI partners,… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …growth, with a strong emphasis on quality control and improvements to enhance claims processing stability, flexibility, and innovation. The Director will be ... About The Role The Director of Application Support and Quality Assurance will...Payer or TPA setting. + Extensive background in understanding claims system configuration including, benefit plans, accumulator… more
- Clay Lacy Aviation (Van Nuys, CA)
- …unwavering integrity, and a commitment to excellence. We are seeking a forward-thinking Director of Total Rewards who shares our passion for elevating every detail ... that's redefining what it means to be thoughtfully better. Position Summary The Director of Total Rewards is a strategic leader responsible for the compliant,… more
- McLaren Health Care (Flint, MI)
- …and risk arrangements and actuarial precepts). + Two (2) years' experience in claims and enrollment system configuration and maintenance. + Two (2) years' ... We are looking for a Director , MIG Operations, to join us in leading...all operational areas including, but not limited to, membership, claims processing and plan benefits management. Assists where necessary… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- **Job Summary: The Director , Principal Architect - SAP** The Director , Principal Architect - SAP will be part of the SAP COE and will be responsible for leading ... evolving feature set. + **Hands-On Work** : Provide hands-on customization/ configuration support for SAP needs. This role will include...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- AIG (Charlotte, NC)
- …is at the heart of everything we do, from underwriting risks to processing claims . The Information Technology team equips our employees with the latest tools to ... and compliance. How you will create an impact The Director GI International Quality Engineering & Assurance is critical...development principles. + Support key programs such as SCUP, Claims , Japan Transformation, myAIG etc. + Working knowledge of… more
- City of New York (New York, NY)
- …for (1) Administrative Staff Analyst NM III to function as an Executive Director , Data Analytics & Verification who will: - Oversee the management, administration, ... the analysis, design, specification, and cost analysis for installation, configuration , operation, support and maintenance of software/applications. Oversee software… more
- Growth Ortho (Nashville, TN)
- Job Title: Director , RCM Implementation Location: Remote (with limited travel as needed) Reports To: SVP, Revenue Cycle Organization: Growth Orthopedics MSO ... Growth Orthopedics (GO) is seeking an experienced and dynamic Director of RCM Implementation to lead the execution of...Enablement Serve as a key stakeholder in the selection, configuration , and rollout of RCM platforms, automation tools, and… more
- BlueCross BlueShield of North Carolina (NC)
- …applications and processes + System administration to include oversight of system configuration for owned applications. Configuration could be done by internal ... Host billing, provider inquiries into payment integrity interventions applied to their claims , and Legal inquiries) + Oversee or participate in internal committees… more
- Commonwealth Care Alliance (Boston, MA)
- …will not be considered at this time._** Position Summary: Reporting to the Director , Claims Operations & Quality Assurance, the Regulatory Compliance & Audits ... guidance. Cross-Functional Collaboration * Act as a liaison between Compliance, Claims Operations, Cognizant, and Configuration teams. * Participate in… more
- Sharp HealthCare (San Diego, CA)
- …in a health insurance product implementation, benefit/coverage policy development, benefit configuration , or claims role. **Other Qualification Requirements** + ... and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit… more
- Beth Israel Lahey Health (Charlestown, MA)
- …job, you're making a difference in people's lives.** Reporting to the Executive Director of Epic Patient Financial Services - PB, the Senior Epic Operations Analyst ... back-end billing functions and workflows, charge generation and capture, claims generation and reconciliation, remittance posting processes, retro adjudication and… more
- Molina Healthcare (Las Cruces, NM)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems ... leadership based on feedback rom assigned MHI attorney. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting. * Advises… more
- Brookings (Washington, DC)
- …of contact for all supported benefit areas. This position reports to the Director of Benefits. Benefit Program Administration (35%) + Administer the full lifecycle ... and state regulations (eg,ERISA, ADA, HIPAA, FMLA). + With oversight from the Director of Benefits, co-lead the planning and execution of open enrollment, wellness… more
- Zelis (Atlanta, GA)
- …customizations and support testing and client "go-live". + Effectively partner with Edit Configuration and Claims Edit Validation Team to confirm client selected ... follows processes well. + Proactively partner with Client Policy Integration Director for input regarding Pre-Stakeholder meetings to validate pre-production data… more
- SSM Health (Oklahoma City, OK)
- …Sets performance standards, goals for direct reports. Works collaboratively with director and pharmacy leadership to set performance standards for the pharmacy ... and dose. + Prepares annual budget for assigned areas. In collaboration with director and pharmacy leadership develops strategic plan and goals for pharmacy that… more
- Siemens (Peachtree Corners, GA)
- …Project Manager for Electrical Products. This position reports to the Director of GGCS(Government, General Contractor, Solutions) vertical in the Project Management ... Set firm expectations on expected product release dates. Use COMPAS to make configuration changes related to project changes or material adds to orders. Collaborate… more
