- APTIM (Santa Fe, NM)
- **Job Overview:** The Team Lead -- Claims Review is responsible for supervising a multidisciplinary team of claims reviewers, estimators, and ... + Provide coaching, feedback, and refresher training to ensure team proficiency in claims systems and regulations + Coordinate with SMEs, site inspectors,… more
- Humana (Santa Fe, NM)
- …this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all ... some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, and Humana colleagues. After completion of mentored… more
- Brink's (Santa Fe, NM)
- …to participate and grow. Job Description Job Category The Account Services Lead is responsible for account management, customer relations, and customer service and ... support issues initiated by customer and internal personnel + Lead activities of internal groups to evaluate and implement...and metrics + Participate on Customer Scorecard calls + Review and verify penalty calculations due to SLA monthly… more
- Meta (Santa Fe, NM)
- …for maintaining Integrated Master Schedule (IMS) including reporting to site team , leadership and cross-functional partners 5. Lead the identification ... closely within the DEC (Design, Engineering and Construction) Business Controls team and various internal departments including Site Project Management teams,… more
- Molina Healthcare (Albuquerque, NM)
- **Job Summary** The Lead Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team . Designs and develops reporting ... plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates * Assists and...in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at least one line… more
- Molina Healthcare (Roswell, NM)
- …work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... analytic / programming tools. + Coordinates and oversees report generation by team members and distribution schedule to ensure timely delivery to customers, ensuring… more
- Prime Therapeutics (Santa Fe, NM)
- …Quality Assurance and UAT resources to review related test cases and/or scenarios + Lead highly complex projects where the project team will be faced with a ... subject matter expert and mentor for other members of Claims IT team , including cross-training assigned BSAs...obtain signoff of deliverables by all impacted parties + Lead solution design review discussions between IT… more
- Cardinal Health (Santa Fe, NM)
- …messages on an hourly basis. + Mentors new hires; assists + Assists management and team lead with motivating and coaching employees to succeed as needed. + ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- … team + Manages interaction with transportation and logistics, prepare/ review release documentation in conjunction with GPQ, manage invoice discrepancies, ... demand for assigned responsibilities. + Partner with internal to review and streamline demand planning process. + Develop and...ambiguity, curious mindset, adaptative, be a part of a multi- team approach + Ability to work/ lead in… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …expertise and delivery of analyses. + Actively participate in project/study team meetings. Develop statistical sections of protocols; participate in mock-ups, ... review , and approve tables, listings and graphs specifications. +...demonstrated by serving in primary roles as statistician or lead statistician in trial design and analyses. + Experienced… more