- Boston Mutual Life Insurance (Canton, MA)
- …courteous. + Leave our customers and associates "better than where we found them." The Director - Claim Services plays a pivotal role within Boston Mutual, ... for managing and overseeing of all aspects of the Claims Service team for Life and Accident...policies. + Stay informed about changes in regulations affecting Claim services . + Develop and implement risk… more
- Sedgwick (Providence, RI)
- …Fortune Best Workplaces in Financial Services & Insurance Business Development Director - Casualty Claims (Northeast Region) As a Business Development ... rapidly growing, industry-leading global company known for its excellence and customer service . + Leverage Sedgwick's broad, global network of experts to both learn… more
- Humana (Providence, RI)
- …outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or ... **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided… more
- Zurich NA (Providence, RI)
- Professional Liability Claims (Attorney), Claims Construction, (Senior or AVP level) 128423 **Zurich North America is expanding its nationwide Construction ... Professional Liability Claims Team with the addition of a dedicated ...expertise and strategic coordination. + Accurately update and document claim files in accordance with best practices, ensuring data… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies… more
- Commonwealth Care Alliance (Boston, MA)
- …states will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. ... the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible… more
- State of Massachusetts (Boston, MA)
- …or other mission-based organizations * Experience interacting directly with individuals seeking services or assistance * Experience in claims processing and/or ... the Commonwealth are supported and empowered through access to high-quality services that are trauma-informed, culturally responsive, and reflective of diverse… more
- Evolent (Providence, RI)
- …health outcomes and a more connected care journey. We are hiring for a Managing Director , Actuarial Services to join our Finance Team. The candidate selected for ... to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication to key… more
- Dana-Farber Cancer Institute (Boston, MA)
- … to support and grow the Institute's research, clinical, and business missions. The Director of AI Operations and Services leads the development and delivery of ... solutions that support research, clinical, and operational goals. The Director serves as a subject matter expert in AI...a $3-5M budget and oversee AI and data-science core services , including service level agreements with Informatics… more
- Travelers Insurance Company (Providence, RI)
- …needed to the Claim Field organization. + Provide input into to claim practices, marketing strategy and customer services as appropriate to anticipate, ... Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is… more
- CenterWell (Providence, RI)
- … Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary Care work assignments involve moderately complex ... The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
- Commonwealth Care Alliance (Boston, MA)
- …team. Cross-Functional Collaboration * Work closely with network contracting, credentialing, claims , IT, customer service , compliance, and quality teams to ... 011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider… more
- Zurich NA (Boston, MA)
- Executive Underwriter OR AVP, Underwriting Director - Contract Surety 124285 Zurich Insurance is currently looking for an **Executive Underwriter OR AVP, Underwriting ... Director - Core Contract Northeast Region Surety Division.** This is...on assignments of higher technical complexity ensuring a high-level service to customers. Our Underwriters are Client Externally Focused,… more
- Zurich NA (Providence, RI)
- …experience in the Claims or Underwriting Support are OR AVP, Underwriting Director - Energy, Oil, Gas and Chemicals Requirements: + High School Diploma or ... Executive Underwriter OR AVP, Underwriting Director - Energy, Oil, Gas & Chemicals 128378...years. By providing a broad array of products and services , we work with our customers to support their… more
- Humana (Providence, RI)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Providence, RI)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... , requested level of care, and/or requested site of service should be authorized. All work occurs with a...services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups,… more
- Sedgwick (Providence, RI)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director , Clinical Programs **PRIMARY PURPOSE** : **The ideal ... claims and/or managed care. Preferred experience in: client services , clinical operations, and or workers comp claims.... To determine account management strategies related to client service plans; to be responsible for retention of existing… more
- ASM Global (Boston, MA)
- POSITION: Human Resources Director DEPARTMENT: Human Resources REPORTS TO: General Manager FLSA STATUS: Salaried/Exempt LEGENDS GLOBAL Legends Global is the premier ... brands. We deliver a fully integrated solution of premium services that keeps our partners front and center through...for you. Join us! THE ROLE The Human Resources Director at View Boston partners with senior leaders and… more
- Otsuka America Pharmaceutical Inc. (Providence, RI)
- …recommendations on best medical excellence capability for the company. The Senior Director , Medical Affairs Strategy Excellence & Operations will set the direction ... the organization is focused on achieving medical excellence critical priorities. The Sr. Director has a proven track of success in driving unprecedented changes that… more
- State of Massachusetts (Boston, MA)
- …systems to evaluate the medical necessity and appropriateness of requested health care services . The primary purpose of the Director of Pharmacy Benefit Manager ... necessary to thrive to apply for this role. **Job:** **Administrative Services * **Organization:** **Division of Insurance* **Title:** * Director of Pharmacy… more