• Manager, Medical Malpractice and General…

    Community Health Systems (Franklin, TN)
    …the Manager identifies and addresses trends to mitigate risk and improve claims management processes. **Essential Functions** + Manages professional and general ... **Job Summary** The Manager, Medical Malpractice and General Liability Claims ...submissions. + Provides training and guidance to staff on claims management best practices, procedures, and regulatory… more
    Community Health Systems (04/01/25)
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  • Sr Claims Supervisor

    HCA Healthcare (Nashville, TN)
    …department and company strategy and philosophy of proactive, efficient and effective claims management . + Continuous and appropriate documentation within, and ... and administration of special projects as assigned by the Claims Director , HCI President and VP of...industry trends, changes in laws and rules affecting liability claims management decisions. **People** + Work collaboratively… more
    HCA Healthcare (05/08/25)
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  • Medical Director - Medicaid N.…

    Humana (Nashville, TN)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (05/14/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Pacific SW Region

    Humana (Nashville, TN)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (05/10/25)
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  • Medical Director - Care Plus…

    Humana (Nashville, TN)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (04/24/25)
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  • Medical Director - Florida

    Humana (Nashville, TN)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (05/22/25)
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  • Director , Field Reimbursement…

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    Director of Field Reimbursement Management (FRM) Position Overview We are seeking an experienced, transformative leader to serve as the Director of Field ... within the assigned region Key Competencies + Strategic leadership and team management + Patient-centric approach to healthcare delivery + Operational excellence and… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Senior Director , Legal Affairs

    Warner Music Group (Nashville, TN)
    …+ Find creative solutions to complex and atypical issues, with a focus on the management and resolution of incoming legal claims . **Here you'll get to:** + ... Senior Director , Legal Affairs Job Description: At Warner Music...corporate litigation in-house counsel, fielding inquiries and resolving pre-litigation claims from third parties, researching WMG's recorded music catalog… more
    Warner Music Group (05/03/25)
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  • Director , Global Medical

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    The Director , Global Medical Publications will support Otsuka in leading and developing an overall scientific communication strategy for publications and ... congresses, and will work closely with the Global Medical Affairs Teams, Clinical Teams, Global Value & Real-World Evidence Teams, and Publications Management more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Corporate Medical Director

    Humana (Nashville, TN)
    …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
    Humana (04/24/25)
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  • Director , Global Clinical Development

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Experience with the… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Complete understanding of… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Market Director of Utilization…

    Ascension Health (Nashville, TN)
    …market. Must be located with in the TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, you'll ... optimize patient care and partner with the National Senior Director of UM to align on organizational goals. Ready...within the insurance plan. + Ensure integration of utilization management functions with network strategy and claims more
    Ascension Health (04/25/25)
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  • Medical Director - Medicare…

    Humana (Nashville, TN)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (05/14/25)
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  • Product Management Director

    Elevance Health (Nashville, TN)
    **Product Management Director - Provider Workflow & Quality Solutions** **Location:** Alternate locations may be considered. This position will work a hybrid ... life through home-care and community based services. The **Product Management Director ** will lead our Provider Workflow...with FHIR, HL7, or X12 standards for clinical and claims data preferred. + Experience working with provider groups,… more
    Elevance Health (05/22/25)
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  • Sr Director , Performance Suite Analytics

    Evolent (Nashville, TN)
    …health outcomes and a more connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected for this role will be part ... and its customers in the Performance Suite where Evolent does not pay claims + Establish ideal data transfer protocols during client onboarding and implementation,… more
    Evolent (05/02/25)
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  • Director , Specialty Pharmacy Operations

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …Specialty Pharmacy operations for OAPI The position will report to the Executive Director , Channel Strategy and Patient Affordability We are seeking a highly skilled ... and motivated Director of Specialty Pharmacy Operations to lead and oversee...with cross-functional teams, including Brand Marketing, Sales, Patient Access, Medical Affairs, and Regulatory, to integrate pharmacy operations seamlessly… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Senior Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Associate Director , Established Brands…

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
    Otsuka America Pharmaceutical Inc. (05/16/25)
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