- Humana (Lansing, MI)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- University of Miami (Miami, FL)
- …and documentation of potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and Assistant General Counsel. Conduct ... Management has an exciting opportunity for a full-time Director , Risk Management to work on the...shall provide consultation to UM leadership that includes: Senior Management , Faculty and Staff, Medical Leadership and… more
- CenterWell (Boston, MA)
- …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
- Humana (Indianapolis, IN)
- …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 (Little Rock, AR)
- …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
- Guthrie (Cortland, NY)
- …as necessary with the hospital Business Office, physician offices, Care Coordination, Medical Director and other hospital departments as appropriate. + Serves ... Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination,...requirements and to assist in ensuring generation of clean claims in a timely manner + Securing authorization as… more
- Guthrie (Towanda, PA)
- …Leads any payer specific external claim audit activity, worked in combination with Management , Compliance, Medical Records and Clinical Operations. 9. Serves as ... Insurance Billing Specialists I and related support staff. Works closely with Director , Manager, Supervisor and Application Analyst on day to day priorities and… more
- Fluor (Greenville, SC)
- …and resolution of claims * Work with Construction, Engineering, Supply Chain Management , Legal, and Insurance and Risk Management to assist in facilitating ... Defense and the Intelligence Community. **Job Description** This position assists in the management of prime contracts in conjunction with the Project Director … more
- ABM Industries (Atlanta, GA)
- …Design and implement best practices, policies, and procedures to ensure efficient claims management and regulatory compliance. + Continuously assess the ... **Overview** The Director of Workers' Compensation Claims is...evaluate performance of external partners, including TPAs, legal firms, medical management vendors, and investigative services. +… more
- AIG (Jersey City, NJ)
- Claims Complex Director - Healthcare Professional... portfolio of the most complex and high exposure medical malpractice (and some GL) claims at ... Liability (HPL) Join us as a Claims Complex Director to take on key...+ Keeps abreast of significant changes in the law, claims and industry trends (not limited to medical… more
- Robert Half Legal (Farmington Hills, MI)
- …A prominent Michigan-based organization in the insurance sector is looking for a dynamic Claims Director . This position is ideal for an experienced leader with ... expertise in claims management , litigation oversight, and operational strategy....to ensure accuracy and compliance. + Support the executive director and collaborate with leadership on organizational strategy and… more
- WTW (Chicago, IL)
- …clients of their claim related obligations under the policy and establish client-specific claims management procedures + Provide claims advocacy on behalf ... **Description** **The Role** This role provides value-added claims leadership and management service for the management liability lines of coverage, acts as… more
- Elevance Health (Mendota Heights, MN)
- ** Director II, Digital Claims Operations (Dir II Digital Ops)** Location: This role requires associates to be in-office **3 days per week** , fostering ... considered if candidate resides within a commutable distance from an office._ The ** Director II, Digital Claims Operations** oversees a combined digital and… more
- Sedgwick (Austin, TX)
- …fulfill those needs. **QUALIFICATIONS** + Ten (10) years of relationship building in the claims management or risk management area or equivalent combination ... Best Workplaces in Financial Services & Insurance Business Development Director - Casualty Claims (Dallas, TX) As...**Experience:** Ten (10) years of relationship building in the claims management or risk management … more
- Sedgwick (Concord, NH)
- …a plus, not required. **Experience:** Ten (10) years of relationship building in the claims management or risk management area or equivalent combination of ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Business Development Director - Casualty Claims (Northeast Region) As a Business Development… more
- Sedgwick (Montgomery, AL)
- …+ Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Director - Claims (REMOTE) Are you looking...preferred. Licenses as required. **Experience** : Ten (10) years claims management experience including three (3) years… more
- AdventHealth (Orlando, FL)
- …+ 2 years experience in/as one of the following: clinical healthcare professional risk/ claims management attorney or paralegal [Required] This facility is an ... of claims ._ + _Analyzes and reports aggregate claims data to Department Director /VP as requested._...and patient safety activities. [Required] + Understanding of the claims /litigation prevention and management process. [Required] +… more
- Marriott (Bethesda, MD)
- …caseload of workers' compensation and liability cases as determined by the Senior Director , Global Claims . + Acceptable caseloads vary based on the ... jurisdiction(s), mix and complexity of cases as determined by Senior Director , Global Claims ; + Coordinate decision making on workers' compensation, auto and… more
- University of Miami (Miami, FL)
- …and documentation of potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and Assistant General Counsel. + Conduct ... reportable events and prepare submission for approval by Associate Medical Risk management Officer and the Chief...and physicians in sensitive situations involving actual or potential claims . + Analyze and trend data as captured through… more
- BrandSafway (Atlanta, GA)
- …collaboration with the Senior Counsel for Insured Litigation and the Senior Director - Global Risk Management perform comprehensive internal claim/reserve ... direction of the Senior Counsel - Insured Litigation and Claims will (1) manage assist with managing "Insured Litigation...parties like actuaries, brokers and insurance carriers. Support Senior Director - Global Risk Management as needed… more