- Prime Healthcare (Ontario, CA)
- …+ A minimum of seven (7) to ten (10) years prior work experience in Claims Operations and Health Plan Strategy, in a Managed Care, Self-Funded or hospital ... requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the development and execution of Claim … more
- Humana (Sacramento, CA)
- … Research & Resolution-a key leadership role where you'll drive critical claims operations , oversee complex investigations, and ensure fair settlements for ... a dedicated team, and shape the future of our claims process. You'll have the autonomy to set objectives,...and help us set the standard for excellence in claims management. **Key Responsibilities:** + Oversee the end-to-end … more
- Zurich NA (Gold River, CA)
- …liability claims + Experience managing construction. + People management experience + Claims operations experience + Knowledge and skill in claims ... Claims Team Manager, General Liability 125560 Zurich North...moderate oversight, leads and directs a team of technical Claims Professionals in Commercial General Liability claims .… more
- Walmart (Apple Valley, CA)
- …versustraining Determines training needs Develops and delivers training as needed Manages claims and receiving operations by ensuring proper policies and ... and collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing… more
- HCA Healthcare (Campbell, CA)
- …physician and ancillary agreements and Letters of Agreement + Working knowledge of claims operations , credentialing process and overall MSO operations + ... of the Contracting Team include the CEO, CFO, President of SCCIPA, AVP Claims and Manager of Network Operations . We want you to apply! What you will do in this… more
- Sanofi Group (Los Angeles, CA)
- …deep operational knowledge of the US healthcare system, including formulary operations , claims adjudication, specialty pharmacy networks, and contract ... **Job Title:** Associate Director, National Account Operations CVS - US Remote **Location:** Remote/Field Based...Based **About the Job** The **Associate Director, National Account Operations ** is a key strategic and executional leader within… more
- Providence (CA)
- …statements for services and take proper steps to pay vendors + Inform Senior Manager Operations of large or complex claims and claims with potential for ... empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, general,… more
- Actalent (Redlands, CA)
- …and collaborative Provider Data Analyst to support our credentialing and claims operations . This role involves converting and interpreting provider ... Job Title: Provider Data Analyst - Credentialing & Claims Support Position Overview: We are seeking a...determine provider status (contracted vs. non-contracted). + Assess whether claims can be routed to existing provider profiles or… more
- Providence (Irvine, CA)
- …+ Experience working collaboratively with cross-functional teams including risk, compliance, claims , and operations . + Superior communication skills in both ... and case strategy. This role works closely with Risk Management, Compliance, Claims , and operational leaders to protect the organization's interests while advancing… more
- Highmark Health (Sacramento, CA)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations , Customer Service, Regulatory Affairs, IT, Legal and other departments, ... and industry regulatory changes and assess their potential impact on Claims Operations , Customer Service and other operational areas processes and collaborate… more