- Humana (Sacramento, CA)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Sacramento, CA)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- HUB International (Encino, CA)
- …from HR managers to corporate risk managers + Collaborate closely with the dedicated claims director and account service teams to ensure seamless client service ... plan and more! **THE OPPORTUNITY:** We are seeking an experienced Workers' Compensation Claims Advocate to join our dedicated team supporting a top producer with a… more
- Sedgwick (Sacramento, CA)
- …visit for the claim. + Maintains communication with the customer, Client Service Director , and Claims Examiner providing timely updates on changes in injured ... guidelines. + Maintains ongoing communication with the client, Client Service Director , and Claims Examiner until the assigned Field Case Manager arrives onsite.… more
- Zurich NA (Sacramento, CA)
- Sr. Claims Specialist - Complex Construction 126105 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our Complex ... team. This role is essential in managing complex, high-exposure construction, and litigation claims , while supporting the New York Labor team to ensure claims … more
- Unilever (El Segundo, CA)
- …out-of-the-box thinker to join our R&D Scientific Affairs team as the Claims Substantiation Lead (Associate Principal Scientist) Reporting to the Sr. Director ... Scientific Affairs. This role will be responsible for managing claims substantiation for all current products and campaigns as...products and campaigns as well as future innovations. The Claims Substantiation Lead will be an integral member of… more
- Fluor (Fresno, CA)
- …Central Valley. Under the general direction of the Director and Deputy Director of the PMO/forensics & Claims , this role is responsible for developing ... also responsible for reviewing and analyzing Contractors' Time Impact Analyses and claims and assisting with the rebuttal responses. In addition to forensic analysis… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp Health Plan's (SHP) ... practice of medicine. + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons License - Medical Board of CA -REQUIRED… more
- University of Southern California (Los Angeles, CA)
- …Director , Health PlansApply (https://usc.wd5.myworkdayjobs.com/ExternalUSCCareers/job/Los-Angeles-CA University-Park-Campus/Associate- Director ... itsHealth Plansteam! The Work You Will Do The Associate Director , Health Plans manages major components of the University's...and innovation. Manages and resolves human resource and member claims and plan related issues. . Plans and conducts… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible for certain assets ... the broader overall TA strategy determined by the Sr. Director , Franchise Lead CNS Early Assets. **Position Summary:** The...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more