• Claims Operations Director

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** We are seeking an experienced and dynamic Claims Operations Director to join our team and oversee our claims management ... the quality and efficiency of our claims processes. The Director of Claims Operations has overall responsibility and accountability for effectively and… more
    CareFirst (03/10/25)
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  • Claims Manager - Liability - REMOTE

    Ryder System (Austin, TX)
    …by a professional staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues. Assists Director ... a team of adjusters in the investigations, vehicle inspections, and resolves claims , as well as directs outside vendors, independent adjusters, experts, and other… more
    Ryder System (02/25/25)
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  • P&C Senior Director - Pricing, Product,…

    WTW (Miami, FL)
    …lines insurance experience to join as a Property & Casualty (P&C) Senior Director in our Insurance Consulting and Technology (ICT) practice. In this role, you ... America P&C propositions, especially in the business-focused areas of Pricing, Product, Claims and Underwriting. Our goal is to substantially increase our footprint… more
    WTW (03/26/25)
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  • Director , Health Plan Operations

    Molina Healthcare (Meridian, ID)
    …Information Management, Provider Data Management, Credentialing, Enrollment, and Contact Center Operations . * Oversees Claims Operations and Configuration ... **Job Description** **Job Summary** Molina Health Plan Operations jobs are responsible for the development and...business owners to ensure the health plan processes for claims and encounters, aligns with regulatory requirements for each… more
    Molina Healthcare (03/04/25)
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  • Director , Special Investigations Unit,…

    Molina Healthcare (Scottsdale, AZ)
    **Job Summary** Acts as liaison between Special Investigations Unit (SIU) operations and health plans and internal functional teams to assure a smooth workflow ... achieved. Coordinates with Associate Vice President, Special Investigations Unit, Regulatory Operations (AVP- SIU) within to oversee the special investigations unit… more
    Molina Healthcare (03/15/25)
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  • Healthcare Medical Claims Coding Sr.…

    Commonwealth Care Alliance (Boston, MA)
    011250 CCA- Claims **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration… more
    Commonwealth Care Alliance (03/04/25)
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  • Prefill- Claims Adjuster (Powertrain)

    Insight Global (Norcross, GA)
    …pre-paid maintenance claims . The Claims adjuster will report to the Senior Director of Claims Operations and Field Support and functions as a ... the auto industry. Our customer is looking for Powertrain Claims Adjusters to join their team.. As an adjuster...Tech Savvy / Ability to efficiently work in a remote environment Quiet working environment with no distractions (Area… more
    Insight Global (04/01/25)
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  • Field Reimbursement Director - EAST…

    Danaher Corporation (Boston, MA)
    …the Danaher Business System which makes everything possible. The Field Reimbursement Director position is a provider / customer facing role responsible for ... coordinate and engage targeted customers within the US. Reporting to the Senior Director of Market Access Americas, this highly visible role will play a pivotal… more
    Danaher Corporation (04/01/25)
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  • Remote Medical Director - Texas

    Centene Corporation (Austin, TX)
    …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
    Centene Corporation (03/15/25)
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  • Director , Configuration (Medicaid…

    Molina Healthcare (Bellevue, WA)
    …including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure ... * Establishes and maintains benefits, provider contracts, fee schedules, claims edits, and other system settings in the claim...with a focus on goals and improvement to daily operations . + Build and maintain strong trusted relationships with… more
    Molina Healthcare (03/21/25)
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