- Merck & Co. (North Wales, PA)
- Job DescriptionThe Omnichannel OME Activation Director will play a key leadership position in the US market driving the best in class omnichannel strategy with the ... well as deep technical understanding of Life Sciences data sets (eg, claims , electronic health records) and advanced modeling approaches. Using this expertise, this… more
- Merck & Co. (Rahway, NJ)
- Job DescriptionThe Executive Director of Global Marketing for HIV - Long-Acting Treatment Programs, will be at the forefront of driving our global commercial success ... to shape the commercial HIV product profile, label, core claims document and value.Work with cross-functional colleagues to ensure...of twelve (12) months of service in current position prior to applying for open positions.If you have been… more
- FUJIFILM Holdings America Corporation (College Station, TX)
- …monitoring employee well-being; investigating and reporting to the Supervisor / Director of Human Resources the results of investigations, coordinating disciplinary ... actions and claims of potential discrimination or harassment; providing proposed solutions as well as developing a close partnership between Human Resources and… more
- CVS Health (Columbus, OH)
- …done from your laptop. Fundamental Components: * Utilization management - The medical director will perform concurrent and prior authorization reviews with peer ... to its membership. Aetna is looking for a medical director to be part of a centralized team that...plus. Preferred Qualifications: Previous Experience in Utilization Management / Claims Determination with another Health Plan / Payor or… more
- Sedgwick (Uniondale, NY)
- …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Claims Workers Comp & liability **PRIMARY PURPOSE** : To be ... and/or AIC certifications preferred. Licenses as required. **Experience** Ten (10) years claims management experience including three (3) years prior supervisory… more
- HomeSafe Alliance (Columbus, OH)
- …as needed to ensure prompt recovery of claim expenses. + Work with the Director of Claims and Claims Managers to ensure any concerns or issues ... settlement practices, trends, or areas of concern to the Director of Claims . Responds to internal and...4-year degree preferred + Minimum 3-4 years personal property claims adjusting experience preferred + Prior experience… more
- MyFlorida (Tallahassee, FL)
- …in monthly performance measure reports and provide findings and recommendations to the Division Director prior to the Deadline set by the CPO. + Manage the ... of the Division's performance measures, which will be reported to the Division Director and the Department's Chief Performance Officer (CPO). + Research and evaluate… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …examiners and claim adjusters in responding to insured commercial property claims * Review and determination of complex coverage issues * Maintains reports on ... Property Claims Manager (State Risk Adjuster 6) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4476650) Apply Property Claims Manager… more
- Illumination Foundation (Santa Ana, CA)
- …the standards of our contracts and programs. + Verify eligibility of each client prior to creating and submitting claims . + Have knowledge in understanding, ... EOB's and Remittance Advice + Posting payment accurately to claims and continuing with the claim close...Verifying client's insurance falls into one our contracted insurance prior to billing + Following up on claims… more
- Universal Health Services (Madera, CA)
- …able to recognize when needs to confer with doctor, house/nursing supervisor, or program director prior to making decisions. + Utilizes a manner that is friendly ... criteria. + Completes quality and timely appeal/denial letters. Participates in post claim recovery review and ongoing audit activity, supporting compliance with CMS… more
- Beth Israel Lahey Health (Plymouth, MA)
- …and any other parties who may be relevant parties in a malpractice or liability claim . + The Director will oversee the Risk Specialists as they provide ongoing ... served in the hospital. **Duties/Responsibilities:** Under the guidance of the Senior Director of Quality and Patient Safety, members of Senior Leadership and others… more
- Commonwealth of Pennsylvania (PA)
- Director , Division of Finance (Audit Manager) Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4423265) Apply Director , Division of Finance ... accounting? The Department of Health (DOH) is seeking a Director , Division of Finance to join our team in...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- HUB International (Carlsbad, CA)
- …+ Aware of relevant insurance legislation and major insurance-related court decisions + Prior experience in claims consultation with larger risk accounts + ... **Professional & Executive Risk Claims Advocate** **Position Summary** Working within the ...on behalf of client + Consultation with clients on claim issues involving Directors & Officers, Errors & Omissions,… more
- Travelers Insurance Company (Hartford, CT)
- …$174,800.00 **Target Openings** 1 **What Is the Opportunity?** Join us as the Director , Business Delivery - Claim and champion transformative initiatives shaping ... you do and where you do it. **Job Category** Claim , Operations, Product **Compensation Overview** The annual base salary...+ 8+ years of related experience is preferred + Prior experience in strategy development is preferred + … more
- BeiGene (San Mateo, CA)
- …with CPT, HCPCS, ICD-10 revenue codes. + Familiarity with health insurance claim forms, explanation of benefits, prior authorization forms, and EMR/Practice ... **General Description:** The Northeast Division Field Reimbursement Director (FRD) helps minimize access & reimbursement barriers for patients and providers to… more
- CVS Health (Springfield, IL)
- …Medical Director include support of the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits in the ... Health company has an outstanding opportunity for a Medical Director . Ready to take your career to the next...Aetna clinical and coding policy and experience with appeals, claim review, reimbursement issues, and coding is preferable, but… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- …and no significant restriction on moonlighting The Home Based Primary Care (HBPC) Medical Director serves as the physician member of the HBPC leadership team and as ... provider for veterans enrolled in HBPC. The HBPC Medical Director is part of the Geriatrics, Palliative, and Extended...subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested… more
- Montana State University (Bozeman, MT)
- …position, please contact: Chris Dobbs, ###@montana.edu, ### Classification Title Managing Director Working Title Director of Development and Membership Brief ... a creative and experienced fundraiser to be its next Director of Development and Membership. The Director ...of employment is contingent upon availability of funding. Candidates: Prior to applying, candidates should carefully review minimum and… more
- CVS Health (Boston, MA)
- …quality assurance while being responsible for predetermination reviews and review of claim determinations. + This includes Prior Authorization / Pre ... hospitals, outpatient networks, and value-based care relationships. The Medical Director will be required to have a Massachusetts state...required to have received at least one COVID-19 shot prior to your first day of employment and to… more
- Humana (Columbus, OH)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director (Staff Geriatrician or Physician with Ten (10) ... or Physician with Ten (10) Years of Clinical Practice with Older Adults (Medical Director ) is dedicated full time to the Indiana Pathways program to assist the… more
