- Merck & Co. (San Antonio, TX)
- Job DescriptionThe-Oncology Regional-Medical Scientific Director ,-RMSD, is a credentialed (ie,-PhD,-PharmD,-DNP, MD) therapeutic and disease expert who engages in ... Scientific Congress Support, and Scientific Insights. Location: This MSL-type role is a remote position that serves the territory of TX & OK. This person must… more
- Merck & Co. (Rahway, NJ)
- Job DescriptionThe Associate Director , Business Insights & Analytics, Cross US Vaccines will be responsible for developing and communicating data-driven and ... analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization… more
- Molina Healthcare (West Valley City, UT)
- …experience. **Required Experience** * 7 years' experience in healthcare claims review and/or Provider appeals and grievance processing/resolution, including 2 ... years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery, Anesthesia, high… more
- RTX Corporation (Boston, MA)
- …Posted:** 2025-06-18 **Country:** United States of America **Location:** RMA99: RTN Remote , Massachusetts **Position Role Type:** Remote **U.S. Citizen, US ... (LCC) is seeking an experienced Supply Chain Counsel. Reporting to the Raytheon Executive Director & Lead of AXL, this position will provide legal advice and counsel… more
- Sedgwick (Charlotte, NC)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director - Client Services ( REMOTE ) Are you looking for an opportunity to ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- GuideOne Insurance (Atlanta, GA)
- As the Director of Data Platform and AI, you will lead the evolution of our enterprise data infrastructure while spearheading the development of intelligent AI ... of AI and machine learning to address business challenges in underwriting, claims , and service operations. Success in this role demands a pragmatic, collaborative… more
- Sanofi Group (Denver, CO)
- **Job Title:** Associate Director , National Account Operations UHG - US Remote **Location:** Remote /Field Based **About the Job** The **Associate Director ... knowledge of the US healthcare system, including formulary operations, claims adjudication, specialty pharmacy networks, and contract performance tracking. We… more
- Merck (Atlanta, GA)
- **Job Description** The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages ... and Scientific Insights. **Location:** This MSL-type role is a remote position that serves the territory of TX &...areas of interest _*Scientific exchange does not include promotional claims about any drug, vaccine, or biologic product. RMSDs… more
- Centene Corporation (Jefferson City, MO)
- …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- BrightSpring Health Services (Louisville, KY)
- …are looking for career progression! Step Into a Rewarding Role as a Claims Analystwith PharMerica! The3rd Party Claims Analystis responsible for configuring ... our proprietary system, and monitoring and evaluating events related to 3rdparty claims . The 3rdparty analyst will interact with appropriate departments to ensure… more
- Sedgwick (Pittsburgh, PA)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Client Services Director | REMOTE | Casualty/Workers Compensation Experience required + ... 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
- GuideOne Insurance (Dallas, TX)
- As the Director of Enterprise Architecture, you will be responsible for leading the architecture strategy, governance, and execution across infrastructure, ... in driving governance and modernization initiatives across multiple domains. As the Director of Enterprise Architecture, you will lead the Architecture Review Board… more
- Two95 International Inc. (Atlanta, GA)
- Job Title: Director , Health Plan Analytics Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Position Summary: As ... the Director of Analytics, you will lead a team of...including but not limited to enrollment, finance, call center, claims , Case Management and Utilization Management * 5+ years… more
- NTT America, Inc. (Plano, TX)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Global AI Director , Insurance - REMOTE to join our team in Plano, Texas ... (US-TX), United States (US). As an AI Director aligned to the Insurance sector, you will play a pivotal role in shaping and executing our global AI strategy. You… more
- BJs Wholesale Club (Marlborough, MA)
- …counsel and TPA. + Identifies claim trends and provides recommendations to the Claims Manager and Director , Risk Management, and Insurance for decreasing the ... members receive the best possible care, provides oversight of third party claims administrator (TPA) to achieve optimal financial results; partnering with clubs/DC's… more
- AdventHealth (Altamonte Springs, FL)
- …even better. **Schedule:** Full Time **Shift** : Monday - Friday **Location:** Remote **The role you'll contribute:** This position is responsible for the management ... of assigned potential compensable claims , asserted claims and suits. Management encompasses...Defense counsel is assigned in consultation with the Department Director . + Litigation plan is discussed with defense attorneys,… more
- Commonwealth Care Alliance (Boston, MA)
- …for One Year Term **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration… more
- Robert Half Legal (Los Angeles, CA)
- Description Director , Corporate Restructuring - Remote (US Based) We are working with a highly regarded, long-standing organization that provides specialized ... or consulting within the corporate bankruptcy space. + Strong expertise in claims and noticing, financial restructuring, and Chapter 11 case administration. +… more
- UPMC (Pittsburgh, PA)
- …a place for you. UPMC Health Plan's growing Actuary department is seeking a Director , Actuary to ensure that the UPMC Health Plan Actuarial Department provides the ... the financial reporting department to develop reserve amounts for IBNR claims , active claims and premium deficiency reserves on a regular or as-needed basis.… more
- Stanford Health Care (Palo Alto, CA)
- …**This is a Stanford Health Care job.** **A Brief Overview** The Director , Professional Billing Organization (PBO) manages all administrative and clinical functions ... by School of Medicine faculty and Stanford Medicine Partners physicians. The Director , PBO is responsible for enhancing and maintaining cash flow, revenue cycle… more
