- Sedgwick (San Antonio, TX)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Management and Executive Risk Claims Manager **PRIMARY PURPOSE** **:** To manage the ... policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- Molina Healthcare (San Antonio, TX)
- …cutover planning, and post-go live stabilization. + Hands-on governance, quality assurance, risk management , and escalation handling in a regulated environment ... requirements, configuration, and testing for platforms such as Salesforce (case management , integrations), QNXT (or similar core claims ), RPA/automation, and… more
- Wells Fargo (San Antonio, TX)
- …Qualifications:** + 4+ years of Fraud Claim Investigations or Policy Violations, Risk Management or Compliance experience, or equivalent demonstrated through one ... this role:** Wells Fargo is seeking a Fraud & Claims Operations Manager. You will lead a team of...actionable trends + Experience communicating with and presenting to executive leaders + Excellent communication and interpersonal skills, with… more
- USAA (San Antonio, TX)
- …Opportunity** As a dedicated **Strategic Account Relationship Manager Senior for Claims Optimization** , you will be responsible for developing, managing, growing, ... are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. **What you have:** + Bachelor's… more
- Sedgwick (San Antonio, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Executive General Adjuster - Southwest Region **PRIMARY PURPOSE** : To investigate … more
- Sedgwick (San Antonio, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Executive General Adjuster - Southwest Region **PRIMARY PURPOSE** **:** To investigate… more
- Wells Fargo (San Antonio, TX)
- **About this role:** Wells Fargo is seeking a Fraud Product Management Executive to develop innovative fraud management capabilities that minimize customer ... experiences for our 70 million valued customers/7,500 fraud and claims employees. The solutions you and your team will...ensuring regulatory and policy compliance. + **Product Operations and Risk Management :** Own and prioritize the long-term… more
- Molina Healthcare (San Antonio, TX)
- …of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management , Network, and other departments to enable critical ... sources. + Knowledge of healthcare operations (utilization management , disease management , HEDIS quality measures, claims processing, etc.) + Knowledge of… more
- HUB International (San Antonio, TX)
- …is a global insurance broker providing a broad array of property, casualty, risk management , life and health, employee benefits, investment and wealth ... management products and services. HUB has more than 650...Account Manager works collaboratively with the Producer, and Account Executive to manage a book of business. Coordinates and… more
- Molina Healthcare (San Antonio, TX)
- …contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability ... meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding. * Independently delivers… more
- Molina Healthcare (San Antonio, TX)
- …weekly/monthly/quarterly/annually standard reports. + Must have experience in analyzing Utilization management , member health risk assessment data using SQL, ... **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network...using PowerBI + Must be able to collaborate with Executive teams in Utilization management , Operations, Core… more