- Sedgwick (Columbus, OH)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... casualty workers compensation industry background and skill set. Managing and understanding claims data & casualty claims data.** **PRIMARY PURPOSE** **:** To… more
- Zurich NA (Cincinnati, OH)
- …leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We ... position you will be responsible for the overall account management , business development and analysis of a highly complex...and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Evolent (Columbus, OH)
- …primarily focused on performing medical economics analysis in support of complex risk -based contract development and will partner with stakeholders of various levels ... across analytics, finance, and account management . **What You Will Be Doing:** + Develop and...presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based… more
- Sedgwick (Cleveland, OH)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... - Mid Atlantic Region **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance...+ Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently… more
- Sedgwick (Dayton, OH)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... Adjuster - Mid Atlantic Region **PRIMARY PURPOSE** **:** To investigate losses or claims internationally on any size National Account (Maintaining a minimum of five… more
- Prime Therapeutics (Columbus, OH)
- …with assigned customers as well as ensuring ongoing contract performance through risk management activities including assurance of Service Level Agreement ... for the assigned account(s). + Ensures contract performance through risk management activities including such items as...as assurance of Service Level Agreement performance in Care Management Centers and Shared Services, assurance of claims… more
- Zurich NA (Cleveland, OH)
- …leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We ... and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is… more
- Molina Healthcare (Columbus, OH)
- …of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management , Network, and other departments to enable critical ... + Knowledge of healthcare operations (utilization management , disease management , HEDIS quality measures, claims processing, etc.) + Knowledge of… more
- Molina Healthcare (Cincinnati, OH)
- **Job Description** **Job Summary** The AVP, Risk Adjustment Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of ... integrity of enterprise revenue, and enabling the organization's overall risk adjustment strategy. Knowledge/Skills/Abilities + Responsible for encounters accuracy &… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …external pressures (eg, 340B, patient leakage) and internal shifts (eg, LOE management , innovative distribution models), this role will be critical in anticipating ... Responsibilities:** + **Proactive Program Optimization:** Own the end-to-end performance management process for affordability and channel programs across in-line… more