- Sedgwick (Madison, WI)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for ... managing SIU investigations of complex fraud schemes involving providers, vendors, attorneys and others;...degree from an accredited college or university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI),… more
- Humana (Madison, WI)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to … more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …Founded on Otsuka's rich history in delivering breakthrough innovations to solve complex problems for patients, Otsuka Precision Health (OPH) is the next step ... health experience, one connection at a time, together. The ** Director , Digital Health Corporate Counsel** will be responsible for...with other members of the OPH Legal team on complex matters and matters of first impression, as well… more
- Evolent (Madison, WI)
- …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected… more
- Humana (Madison, WI)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Humana (Madison, WI)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- American Family Insurance - Corporate (Madison, WI)
- …Requirements + Demonstrated effective leadership skills. + Demonstrated experience communicating complex claims litigation concepts to business clients in a ... a team of litigation management professionals who manage a portfolio of litigated claims . Executes legal and claims litigation strategy objectives adhering to… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- The Associate Director , Brand and Sales Analytics will be part of a high performing team that provides actionable, innovative solutions to address key business ... questions & opportunities. The Associate Director , Sales & Marketing Analytics should be able to...and effectively with limited supervision, while working across a complex matrix environment that includes areas in marketing, sales,… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …Specialty Pharmacy operations for OAPI The position will report to the Executive Director , Channel Strategy and Patient Affordability We are seeking a highly skilled ... and motivated Director of Specialty Pharmacy Operations to lead and oversee...diverse teams and stakeholders. + Demonstrated ability to manage complex projects, prioritize tasks, and meet deadlines. + Knowledge… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- Director of Field Reimbursement Management (FRM) Position Overview We are seeking an experienced, transformative leader to serve as the Director of Field ... space + Experience in training and developing teams on complex reimbursement topics + Understanding of the "Buy and...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more