- APTIM (Santa Fe, NM)
- **Job Overview:** The Team Lead -- Claims Review is responsible for supervising a multidisciplinary team of claims reviewers, estimators, and ... + Provide coaching, feedback, and refresher training to ensure team proficiency in claims systems and regulations + Coordinate with SMEs, site inspectors,… more
- Sedgwick (Santa Fe, NM)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead | Auto Liability Bodily Injury | Remote Are ... technical staff? If so, this is your opportunity to lead a high-performing team in a role...management reports and takes appropriate action. + Performs quality review on claims in compliance with audit… more
- Carrington (Santa Fe, NM)
- …to reduce costs and eliminate non-essential and manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including, ... team and work remote from home!** The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring...this position is $23.00/hr - $26.50/hr. **What you'll do:** Review reconciliation of all loan advances once the GSE… more
- Carrington (Santa Fe, NM)
- …to reduce costs and eliminate non-essential and manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including, ... Come join our amazing team and work remote from home! The Loss...to and make all corrections identified during the Quality Review Process within 24 hours of receipt. + Responsible… more
- Humana (Santa Fe, NM)
- …this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all ... some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- **Senior Director, Early Development Team Lead ** **Role Summary:** The Early Development Team (EDT) Lead is a critical role - working to deliver Otsuka's ... and bring differentiated medicines to patients. The EDT Leader will lead asset focused multi-disciplinary teams from pre-clinical through demonstration of clinical… more
- Molina Healthcare (Santa Fe, NM)
- …work assignment, prioritization, issue triage etc. * Researches complex issues * Acts as a team lead , assigning and prioritizing work for other team members ... Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data… more
- Molina Healthcare (Santa Fe, NM)
- … team activities and troubleshooting. **Job Duties** + Research, review , and decipher state-specific Medicaid and Medicare reimbursement methodologies for ... **Job Description** **Job Summary** The Lead Analyst, Reimbursement is responsible for administering complex...to accurately request and analyze impact reports of affected claims . + Analyzes, interprets, and maintains configurable tables and… more
- Molina Healthcare (Santa Fe, NM)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager, SIU, the Team Lead is responsible to lead a small team of investigators and ... a team of investigators and analysts, the Team Lead will ensure the Manager is...over utilization by providers and recipients. The position will review claims data, medical records, and billing… more
- Cardinal Health (Santa Fe, NM)
- …Receivable Specialist Lead contributes to Cardinal Health_** The Accounts Receivable Team Lead performs day-to-day A/R functions in addition to leadership ... production goals are met effectively and efficiently. The A/R Team Lead will work within the scope...+ 3+ years' experience with insurance billing and processing claims preferred + Full knowledge of all areas of… more
- Meta (Santa Fe, NM)
- …for maintaining Integrated Master Schedule (IMS) including reporting to site team , leadership and cross-functional partners 5. Lead the identification ... closely within the DEC (Design, Engineering and Construction) Business Controls team and various internal departments including Site Project Management teams,… more
- Humana (Santa Fe, NM)
- …caring community and help us put health first** The State Technology Lead understands departmental and IT organizational strategy and operating objectives, including ... and works closely with the Market CIO, IT Readiness team , IT Program team , Test Leads and...initiatives. + Supports Medicaid IT leadership in preparing readiness review materials. + Acts as a point of delivery… more
- Molina Healthcare (Santa Fe, NM)
- …work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... analytic / programming tools. + Coordinates and oversees report generation by team members and distribution schedule to ensure timely delivery to customers, ensuring… more
- GE Aerospace (Santa Fe, NM)
- …to clients regarding claim accuracy and fraud mitigation practices, as appropriate + Review and adjudicate reinsurance claims , responding to internal and client ... **Job Description Summary** Join our dynamic audit team at ERAC, a corporate holding of GE...holding of GE Aerospace, as a Reinsurance Auditor and lead audits that drive transparency, innovation, and integrity across… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …practices, procedures and controlled documents. + Lead weekly regulatory intelligence team meetings to include review and discussion of ad hoc query ... to the pharmaceutical environment. **Job Description** + Oversee the capture, review , and dissemination of global regulatory news, public commenting opportunities,… more
- Cardinal Health (Santa Fe, NM)
- …messages on an hourly basis. + Mentors new hires; assists + Assists management and team lead with motivating and coaching employees to succeed as needed. + ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …ensure consistency and alignment of messaging across channels. + Serve as a champion and lead Medical Review / Promotional review processes for materials + ... reports directly to the Senior Director, CNS Medical Communications Lead . **Job Description** **Key Responsibilities Include:** **Global Scientific Communication… more
- Highmark Health (Santa Fe, NM)
- …liaison, bridging the gap between business needs and the analytical technology team . The Senior Decision Support Consultant will leverage technical, analytical, and ... The consultant will act as a senior resource within the team , fostering business-to-technical collaboration and providing strategic consultation directly to… more
- Sumitomo Pharma (Santa Fe, NM)
- …Authorities. + Managing responsibilities for direct reports within the commercial regulatory team for both product promotional review and product promotion ... the advertising and promotion of prescription drugs + Guide and/or lead regulatory agency interactions, including communications and meetings + Provide strategic… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …individuals and teams can achieve unprecedented outcomes that ultimately lead to greater responsibility. **Pipeline** Since 2007, OPDC has dedicated ... leading to NDA, BLA, and/or Global filings. **Key Job Responsibilities** + Lead the clinical development strategy and execution for assigned programs after proof… more