- Wittenberg Weiner Consulting LLC (Santa Fe, NM)
- …attention to detail and adherence to FEMA guidelines. Claims Reviewers - Senior ( Team Lead) will objectively review , investigate, process, evaluate ... Copperhead is seeking multiple Claims Reviewers - Senior ( Team Leads) for a potential contract to support disaster relief. This position involves receiving,… more
- General Motors (Santa Fe, NM)
- …and Service Agreement. This review may include dealership practices relative to warranty claims and policy claims . These claims must comply with specific ... Specific responsibilities include: * Determining the compliance of these claims with the rules and policies * Constructing a...employee to feel they belong to one General Motors team . **Benefits Overview** From day one, we're looking out… more
- Walgreens (Los Lunas, NM)
- …experience. + Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Cardinal Health (Santa Fe, NM)
- …as a primary liaison and expert on the business in support of the Litigation team . + Advises business unit leaders on terms, risks and due diligence during mergers ... laws and regulations, including the Anti-Kickback Statute, the False Claims Act, Stark Law, HIPAA and other laws applicable...business clients + Working under the general supervision of senior attorneys and exercising sound judgment as to matters… more
- CVS Health (Santa Fe, NM)
- …we do it all with heart, each and every day. The SIU Senior Investigator conducts complex investigations to effectively pursue the prevention, investigation and ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
- Molina Healthcare (Roswell, NM)
- …for work around Program Valuation on Molina's Risk Adjustment Actuarial team . Responsibilities include research, analysis and modeling of complex healthcare ... claims data, pharmacy data, lab data, and Risk Adjustment...decisions + Research and develop reports and analyses for senior management and effectively and concisely communicate results and… more
- Mass Markets (Las Cruces, NM)
- …we need your help in managing call center customer service agents. While your team operate the phone for a variety of commercial, state, and federal projects, you ... support them with your leadership and expertise. As the team coach and leader, you will be directly responsible...productivity of direct reports + Responsible for weekly payroll review and submission to ensure correct entries + Responsible… more
- TXNM Energy (Albuquerque, NM)
- …making to ensure the adequacy of insurance coverages, appropriate handling of claims , credit risk monitoring and approvals and the ERM program.. ESSENTIAL DUTIES ... documentation for internal, external and policy audits Serve as Risk Management team backup for internal customers for reporting of potential liability claims… more
- Prime Therapeutics (Santa Fe, NM)
- …Solution Strategist for our NEW JUDI program. If you have experience with PBM/health claims , love working in a fast-paced environment within a group that has a ... you would be responsible for partnering with cross functional stakeholders and senior leaders to implement innovative solutions that advance or achieve Prime's… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …our core business and stakeholders. The Global Integrated Evidence & Innovation team works to achieve these goals by supporting integrated evidence planning, ... a Director to support both Global Integrated Evidence and Digital Health R&D team . The successful candidate will collaborate closely with, and/or be a critical… more