- Molina Healthcare (Bowling Green, KY)
- …they may have technical team members. **Expanded Scope:** The Senior Project Manager for Claims Operations drives complex, multi-workstream initiatives ... on-budget delivery. **Tools/Methods (examples):** Salesforce, QNXT (or similar core claims ), JIRA/Azure DevOps, MS Project /Smartsheet, Visio/Miro/Lucid, SQL,… more
- CVS Health (Nashville, TN)
- …partnering to elevate insights that can positively impact provider experience. The Senior Manager , accounts receivable Diagnostics, will leverage existing & new ... improvements across key provider journeys including self-service / digital transactions, claims management, dispute resolution, and more. They will directly support… more
- CVS Health (Nashville, TN)
- …evolving needs of our business. The Commercial Claim team handles complex project work that crosses many Aetna Technology domains/applications. A Release Manager ... experienced Engineer to join our Commercial Claim Adjudication team. As a Release Manager , you will contribute to product strategy by: + Leading multiple Agile teams… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- …associated regulatory challenges to the GRL, global regulatory team, assigned project teams, and internal/external functional business units as needed. Works ... regulatory challenges to the GRL, global regulatory team, assigned project teams, and internal/external functional business units as needed....you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Molina Healthcare (Bowling Green, KY)
- …recommendations for improvement to decision-makers. At the direction of the Manager , Encounters, collaborates with cross-functional teams to identify and resolve ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… more
- WTW (Nashville, TN)
- **Description** You will serve as the project manager on select projects, interface with vendors and key clients internally and externally, create client ... of the full spectrum of health and benefit programs. You will serve as the project manager on select projects, interface with vendors and key clients internally… more
- Molina Healthcare (Bowling Green, KY)
- …projects + Responsible for analytics and reporting, acting as a Jr Project manager to oversee vendor implementations, coordinating data extractions, gathering ... SQL, PowerBI, databricks. + Experience on ETL , healthcare specifically claims is highly preferred. **JOB QUALIFICATIONS** **Required Education** Associate degree or… more
- Fujifilm (Nashville, TN)
- **Position Overview** The Regulatory Compliance Manager (Corporate) is a member of the FUJIFILM Holdings America Corporation ("HLUS") Department reporting to the ... Corporate Compliance Director. The Compliance Manager will be responsible for managing the day-to-day operations of the company's compliance programs related to laws… more
- CenterWell (Nashville, TN)
- …Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve moderately complex ... factors. The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
- Public Consulting Group (Nashville, TN)
- …a deep understanding of Medicaid waivers. **Duties and Responsibilities** + Serves as project manager and subject matter expert within the practice including ... more, visit www.publicconsultinggroup.com . Summary: We are seeking a senior -level, detail-oriented and self-motivated Medicaid Waiver Evaluation Consultant to join… more
- HCA Healthcare (Nashville, TN)
- …from senior leadership + Works with corporate Payment Compliance manager to effectively identify and communicate issues related to Dispute Resolution inventory ... with developing, and monitoring adherence to, quality assurance standards + Assists manager with implementation and monitoring of project and department action… more