- Molina Healthcare (Atlanta, GA)
- …leadership and direction to MMS Operational Units management staff (eg, Claims Processing, Provider Services, Provider Enrollment, Finance, Managed Care Provider ... Network), for management and supervision of daily functional operations to insure compliance to contract requirements. **Knowledge/Skills/Abilities** * Oversees… more
- CVS Health (Hartford, CT)
- …heart, each and every day. **Position Summary** As a member of the Network Operations Analytics team you will be responsible for the design, development and delivery ... for evolving our current analytical competencies which monitor our claims production environment. By enabling data-driven strategic decision-making, you will… more
- Otsuka America Pharmaceutical Inc. (Montpelier, VT)
- **Position Summary:** The Director GVE Operations oversee and coordinates projects within the department to ensure alignment with organizational goals. This role is ... crucial for enhancing the efficiency and effectiveness of GVE operations to support the timely, efficient, and compliant delivery...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Devereux Advanced Behavioral Health (Braddock, PA)
- …you looking for an opportunity to further your experience in the People Operations (Human Resources) field while having a meaningful impact on people's lives?Do you ... seeking a role that allows you to function as a key member of the People Operations team? **_If you answered Yes, then you'll enjoy working as a People Operations… more
- University of Washington (Seattle, WA)
- …+ Manage vessel maintenance with assistance from Port Engineer + Manage marine operations facilities + Coordinate claims issues with Risk Management and ... have an outstanding opportunity for a **Manager of Marine Operations ** . This person is responsible for organizing and...participate in Quarterly Claims Review meetings + Ensure vessels are operated in… more
- CSL Behring (King Of Prussia, PA)
- …(eg IQVIA claims data) -Experience across all areas of sales operations including sales incentive compensation design and operations , customer targeting, ... As the Senior Director of Sales Operations & COE you will play a key...with responsibility for leading all aspects of sales force operations across the entirety of CSL Behring's US portfolio… more
- Transdev (Phoenix, AZ)
- Overview: The Operations Compliance Manager plays a critical role in promoting a culture of safety, regulatory compliance, and operational excellence across multiple ... obligations that impact driver eligibility, incident response, and safety operations -including both manual and autonomous vehicle environments. Working in close… more
- Travelers Insurance Company (Hartford, CT)
- …from appropriate resources. + Reporting and oversight of real estate investment property claims as well as monitoring or involvement on corporate casualty claims ... Legal and local property managers as needed. May involve claims for other lines of coverage as needed. +...(ie, is executed policy what we agreed to). + Claim tendering, related administration, and negotiation. + Perform other… more
- Community Health Systems (La Follette, TN)
- …experience in understanding the minimum requirements needed for Medicare billing, medical claims processing, or hospital revenue cycle operations required + ... for performing timely and accurate Medicare billing activities, including claims preparation, eligibility verification, census validation, and documentation review.… more
- MAPFRE Insurance (Webster, MA)
- … and policy data. With the graph analytics, the relationship among the claim , the insured, their policy, previous fraudulent claims , are detected. Later, ... is also done in AWS using a Machine Learning Operations module. Once the models are deployed, these are...Claims team finally makes the decision about the claim . 2. A Policy Life Expectancy model, which predicts… more