- LA Care Health Plan (Los Angeles, CA)
- …, the UM Medical Director, physician reviewers, Compliance, Member Services, Provider Network Management , claims teams, and the Center of Quality & Excellence to ... Senior Manager, Clinical and Regulatory Operations Job Category: Management /Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017… more
- Quanta Services (Columbus, OH)
- …relationships and serve as a primary point of contact + Lead change management , claims resolution, and contract administration + Ensure projects meet safety, ... You'll Bring What You Will Bring + Bachelor's degree in Engineering, Construction Management , or related field (or equivalent experience) + 6-10 years of progressive… more
- EMCOR Group (Clemmons, NC)
- …effective response during business disruptions + Oversee the proper handling of risk management claims against the company working with corporate risk ... accurate recordkeeping, strong internal controls, and effective support for operations management in making informed business decisions. + Oversee the development… more
- The Cigna Group (Cleveland, OH)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical Economics, Compliance, ... days per week in the office.** **Assistant Vice President, Provider Network Management , Cleveland and Northern OH (inclusive of Toledo, Akron, Canton, and Youngstown… more
- Dignity Health (Carmichael, CA)
- …events reporting process, root cause analyses, investigations and requests from the claims team (including management of subpoenas, Summons and Complaints, and ... This position is responsible for the design, coordination, implementation and management of the Performance Improvement (PI) plan and identifies opportunities for… more
- Hoffman Construction Company (Lake Oswego, OR)
- …and protect the company's interests. + Perform data analysis to proactively support claims identification and management to mitigate potential legal risk. + ... vital role in maintaining the integrity and performance of the Hoffman Risk Management department. They will report to the General Counsel and support In-House… more
- Carleton College (Northfield, MN)
- …Center and the Human Resources Office. * Maintain insurance, premium, legal, loss, claims , and related risk management records. Risk Mitigation and Compliance: * ... Insurance Manager coordinates, develops, and leads the insurance and risk management functions for Carleton College. This position is responsible for establishing… more
- ARAMARK (Philadelphia, PA)
- …to identify cost-savings opportunities and recommend process improvements. Accident Program Management * Track claims , repair timelines and associated cost. ... programs including fuel, rentals, tolls, licensing/registrations, maintenance and collision management to ensure accuracy, cost control and operational efficiency.… more
- Magellan Health Services (Albuquerque, NM)
- …integration and efficiency of Network strategy and vendor relationships with utilization management and claims processes. Works closely with network on the ... be licensed in the State where they reside. Maintains accountability for medical management functions to achieve the business and clinical outcomes for the health… more
- The Cigna Group (Bloomfield, CT)
- …as a clinical educator and consultant to utilization management , case management , network, contracting, pharmacy, and service operations ( claims ). This is an ... results:** + Performs benefit-driven medical necessity reviews for coverage, case management , and claims resolution, using benefit plan information, applicable… more