- AdventHealth (Tampa, FL)
- …Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient ... care/observation stays and referral services. The Physician Advisor is an important contact for clinicians, external providers, contracted health insurance payors, and regulatory agencies. This individual also serves as the subject matter expert, providing… more
- Kyndryl (New York, NY)
- …programs across Insurance clients in areas such as operational excellence, claims automation, risk mitigation and technology modernization + In depth experience ... to help clients navigate digital disruption, data governance, AI adoption, cloud migration, and cybersecurity challenges. + In depth expertise in either Commercial or Personal Lines, and understanding of the differences between the two with respect to… more
- Geisinger (Danville, PA)
- …reimbursement or recovery recommendations based on PI team's review of claims for appropriate coding, billed statistics, policies, industry standards and compliance ... with contractual, state, and federal regulation. Responsible for the management of the SIU and Program Integrity teams, their contracts and strategies and meeting the financial saving goals set by the enterprise. Job Duties + Provides leadership and strategic… more
- The Cigna Group (Bloomfield, CT)
- …to Have** + Prior **PBM/specialty pharmacy** platform knowledge (eg, claims /benefit management, care coordination, specialty workflows). + Earlier **hands‑on ... engineering** (software, data, or platform) before moving into architecture leadership. + Industry credentials (eg, **TOGAF** , Azure/AWS architecture) and/or published architecture patterns. **Leadership Competencies** + Strategic Mindset, Drives Results,… more
- Brunswick (Mettawa, IL)
- …+ Partner with product management, engineering, creative, supply chain, legal (compliance/ claims ), dealer/channel teams, and brand leads to ensure consistent info ... and on-time launches. + Drive continuous improvement: test PDP variants, schema/structured data optimizations, SEO for product pages, and channel-specific merchandising experiments. + Use data to inform content strategies. Lead A/B testing of ad and PDP… more
- WellSpan Health (York, PA)
- …manner by reducing risk and preventing litigation or costly employee relations claims . + May provide direct supervision to Human Resources Business Partners. + ... If applicable supports contract negotiations and administration, grievance and arbitration management while interfacing with union. **Common Expectations:** + Supports human resources division and entity stewardship efforts. + Maintains established policies… more
- Citigroup (Queens, NY)
- …programs and management of captive insurance company + Execute insurance claims management, oversight of third-party administrators, loss engineering and risk ... control + Insurance support to business units and senior/business risk managers for various business-specific insurance needs including political risks and specific credit insurance placements + Risk management advisory services to business units,… more
- AIG (New York, NY)
- …network. Customers value AIG's strong capital position, extensive risk management and claims experience and its ability to be a market leader in critical ... lines of the insurance business. Corporate Finance - Investment Accounting The Investment Accounting group at AIG is responsible for the accounting and reporting for AIG's Invested Assets of over $95 billion a comprised primarily of fixed maturity securities… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …the organization's insurance programs, including renewals, coverage adequacy, and claims oversight. **This is not a remote opportunity** **Responsibilities** **Job ... wage requirements. Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/14623/ director -of-financial-planning-%26-risk-management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) **Job Locations** _US-NY-East Syracuse_… more
- Blue KC (MO)
- …hospitals, and other providers in the community. + Reviews customer service and claims inquiries. **Minimum Qualifications** + MD or DO degree from an accredited ... medical school required. + 5 + years or experience in direct clinical patient care post-residency or fellowship training. + Board certification in an approved American Board of Medical Specialties (ABMS) specialty with continued certification throughout… more