- Sanofi Group (New York, NY)
- **Job Title:** Associate Director , National Account Operations CVS - US Remote **Location:** Remote /Field Based **About the Job** The **Associate Director ... knowledge of the US healthcare system, including formulary operations, claims adjudication, specialty pharmacy networks, and contract performance tracking. We… more
- Centene Corporation (New York, NY)
- …+ Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Molina Healthcare (Albany, NY)
- …by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- Zurich NA (New York, NY)
- … Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- DIRECTOR #LI- REMOTE EOE Disability / Veterans ... Sr. Claims Specialist - Complex Construction 126105 Zurich North...North America is seeking a skilled and experienced Senior Claims Specialist to join our Complex Liability Claims… more
- Sedgwick (New York, NY)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Client Services Director | REMOTE | Casualty/Workers Compensation Experience required + ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- **Job Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Molina Healthcare (Yonkers, NY)
- …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... **Knowledge/Skills/Abilities** + Holds general oversight of enrollment and premium staff at each plan site within defined region. This may include employee reviews, coaching sessions and disciplinary actions. + Monitors and enforces compliance with… more
- Molina Healthcare (Syracuse, NY)
- …with AI Data Integration._** + **_Experience with Member, Enrollment, and Claims applications -_** **which underpin essential business functions such as HEDIS ... reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License, Certification, Association** Microsoft Technology, Mobility, ITIL To all current Molina employees: If you… more
- Amentum (Albany, NY)
- **Amentum seeks a Director , Insurance and Risk Management.** **Amentum** is a global leader in advanced engineering and innovative technology solutions, trusted by ... Risk Management Team has an immediate opening for a ** Director of Insurance and Risk Management** position to join...growth oriented. US Citizenship is required, this is a remote -telework role, if you live near our Herndon, VA… more
- AON (NY)
- Aon Is Looking for a Director of Travel Insurance Program Development We currently have an exciting career opportunity for a Director of Travel Insurance Program ... Development with a flexible ( Remote /Hybrid) schedule. This position will support Aon's Travel practice...customer value, and profitability. + Leverage data to analyze claims trends and product performance to inform product and… more