- 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 ... them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and... roundtables + Assist in Regional CEO Conferences with Senior Manager Operations + Facilitate and participate… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- **Position Summary** The Senior Manager , Fleet & Samples Operations oversees the execution of field fleet logistics and pharmaceutical sample distribution. The ... Vendor relationship including day to day operations and issue resolution . Escalate issues as appropriate to senior ...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- United Therapeutics (CA)
- …criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution + Educate physician office staff on the use ... collaborative and innovative where you can showcase your knowledge and expertise. The Senior /Therapy Access Manager (TAM) is a customer-facing role that will be… more
- WelbeHealth (Elk Grove, CA)
- …core values and our participant-focus lead the way no matter what. The Senior Manager , Provider Partnership is accountable for overseeing daily operations while ... success in driving provider engagement and operational excellence. The Senior Manager , Provider Partnership plays a critical...the team and the overall provider network _Complex Issue Resolution and Support_ + Act as an escalation point… more
- Walmart (Sacramento, CA)
- **Position Summary ** Job Description Summary The Senior Manager , Construction, is responsible for leading and managing complex construction projects for Walmart ... review pre-construction budgets; track monthly and quarterly budget reports; resolve claims with contractors and estimating department; review and approve contractor… more
- Gilead Sciences, Inc. (Foster City, CA)
- …more tomorrows. **Job Description** Kite is seeking a highly motivated and experienced ** Senior Manager , Sales Analytics and Operations** to join our team. The ... Excellent knowledge of and demonstrated experience with secondary market data including claims data (meaning of data, limitations of data, ability to manipulate,… more
- CVS Health (Sacramento, CA)
- …client expectations and business needs related to plan drafting and issue resolution . Designs and implements processes to ensure efficient, accurate drafting, with a ... compliance impacting plan sponsors. + Collaborate with internal departments-including claims , customer service, and client management-to ensure effective issue … more
- Elevance Health (Los Angeles, CA)
- **Data Quality Consultant Senior ** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training ... quality of life through home-care and community based services. The **Data Quality Consultant Senior ** will be an integral part of the Data Team in leading complex… more
- Highmark Health (Sacramento, CA)
- …review, assisting in navigating a complex regulatory environment, working with claims data, performing financial analyses, and supporting the presentation of ... and testing processes in partnership with the pharmacy benefits manager . The successful candidate will possess excellent communication, analytical, and… more
- NBC Universal (Universal City, CA)
- …The spin-off is expected to be completed during 2025. Summary: The Sr. Manager , Employee Relations & Investigations will serve as a neutral party to investigate ... and facilitate the resolution of concerns of Team Members and managers, involving...for conducting investigations and tracking and documenting employee relations claims and cases. Maintain detailed and accurate accounts of… more