• Medical Director - OP Claims

    Humana (Springfield, IL)
    …Typically reports to Lead depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (11/24/25)
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  • PCO Medical Director - UM - Full…

    CenterWell (Springfield, IL)
    …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
    CenterWell (11/06/25)
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  • Medical Director - Medicaid N.…

    Humana (Springfield, IL)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (10/25/25)
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  • Director Claims

    Ryder System (Springfield, IL)
    …clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Director Claims directs activities within the General and ... Auto Liability Claims , Physical Damage Repairs and Property and Cargo Claims including the management of loss control activities and third-party provider… more
    Ryder System (11/22/25)
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  • Medical Director , Medicare…

    Humana (Springfield, IL)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (11/19/25)
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  • Director II, Digital Claims

    Elevance Health (Chicago, IL)
    ** Director II, Digital Claims Operations (Dir II Digital Ops)** Location: This role requires associates to be in-office **3 days per week** , fostering ... considered if candidate resides within a commutable distance from an office._ The ** Director II, Digital Claims Operations** oversees a combined digital and… more
    Elevance Health (10/10/25)
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  • Executive Director , Medical Affairs…

    Otsuka America Pharmaceutical Inc. (Springfield, IL)
    As a senior leader within Medical Affairs, the Executive Director will serve as a strategic thought partner and Chief of Staff to the Vice President of ... capabilities aligned with Otsuka's vision, direction, and growth strategy. The Executive Director , Medical Affairs Strategy, Excellence & Operations will lead… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Director , Strategic Planning & Operations…

    Otsuka America Pharmaceutical Inc. (Springfield, IL)
    …the asset lifecycle. This role reports directly into the Executive Director , Medical Excellence and Operations. **Job Description** **Key Responsibilities ... The Director , Strategic Planning & Operations is a pivotal...multi-year strategic roadmaps tailored to each therapeutic area **Budget Management ** + Oversee budgets for global medical more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Medical Director Aetna Duals Center…

    CVS Health (Springfield, IL)
    …cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a medical director to be part of a...licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another Health… more
    CVS Health (11/13/25)
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  • Senior Director , Unemployment Cost…

    Experian (Schaumburg, IL)
    …Delivery and Fulfillment. Your role will involve: + Leading and managing the Unemployment Claims Management team to achieve individual, team, and company goals + ... resources and security of Experian. Your role: The Senior Director of Unemployment Cost Management will lead...Maintaining continued improvements of the unemployment claims processing system to drive automation and customer-facing enhancements… more
    Experian (11/25/25)
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