• Medical Director - Claims

    Humana (Lansing, MI)
    …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **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 (11/01/25)
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  • Director , Risk Management

    University of Miami (Miami, FL)
    …and documentation of potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and Assistant General Counsel. Conduct ... Management has an exciting opportunity for a full-time Director , Risk Management to work on the...shall provide consultation to UM leadership that includes: Senior Management , Faculty and Staff, Medical Leadership and… more
    University of Miami (11/06/25)
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  • PCO Medical Director - UM - Full…

    CenterWell (Boston, MA)
    …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 (Indianapolis, IN)
    …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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  • Medical Director - Nat'l UM IP (4x10…

    Humana (Little Rock, AR)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (11/07/25)
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  • Sys Dir Health Info Mgmt

    Rush University Medical Center (Chicago, IL)
    …Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: RUH Health Information Mgmt **Work Type:** Full ... depending on the circumstances of each case. **Summary:** The Director of Health Information Management will lead... record and forms automation, prevent denials related to medical record submission, train staff, ensure timely claims more
    Rush University Medical Center (11/08/25)
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  • LPN-Utilization Mgmt Reviewer - Case…

    Guthrie (Cortland, NY)
    …as necessary with the hospital Business Office, physician offices, Care Coordination, Medical Director and other hospital departments as appropriate. + Serves ... Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination,...requirements and to assist in ensuring generation of clean claims in a timely manner + Securing authorization as… more
    Guthrie (10/28/25)
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  • Insurance Specialist II - Corporate Patient AR…

    Guthrie (Towanda, PA)
    …Leads any payer specific external claim audit activity, worked in combination with Management , Compliance, Medical Records and Clinical Operations. 9. Serves as ... Insurance Billing Specialists I and related support staff. Works closely with Director , Manager, Supervisor and Application Analyst on day to day priorities and… more
    Guthrie (10/22/25)
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  • Manager, Prime Contract Mgmt

    Fluor (Greenville, SC)
    …and resolution of claims * Work with Construction, Engineering, Supply Chain Management , Legal, and Insurance and Risk Management to assist in facilitating ... Defense and the Intelligence Community. **Job Description** This position assists in the management of prime contracts in conjunction with the Project Director more
    Fluor (10/01/25)
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  • Director of Workers Compensation…

    ABM Industries (Atlanta, GA)
    …Design and implement best practices, policies, and procedures to ensure efficient claims management and regulatory compliance. + Continuously assess the ... **Overview** The Director of Workers' Compensation Claims is...evaluate performance of external partners, including TPAs, legal firms, medical management vendors, and investigative services. +… more
    ABM Industries (10/11/25)
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