Strategic Authorization & Referral Claims Lead
$94.9k - $130.5kHumana Inc
Humana Inc. is looking for a Process Improvement Lead to enhance business processes and develop improvements. This role involves substantial collaboration with teams to translate business needs into technical requirements, requiring 2+ years of experience in claims processing and project management. The position involves analyzing operational data, facilitating workshops, and ensuring compliance in process enhancements. Remote work is available, with occasional visits to the office and a competitive salary range of $94,900 to $130,500 per year. Benefits include medical, dental, vision, and retirement savings plans. #J-18808-Ljbffr Humana Inc
$249.97k - $388.13k
...Director, Global Value Evidence Lead, is a strategic leader responsible for... ...application processing fee, even if claimed you will be reimbursed,... ...at: , or your local authorities. Otsuka America Pharmaceutical... ...as a result of an agency referral where no pre-existing...ClaimsTemporary workLocal areaFlexible hours$54.21k - $90k
...difficult general liability claims to determine benefits... ...backup for team lead when out of the office... ...claims within designated authority. Calculates and... .... Coordinates vendor referrals for additional investigation... ...techniques including strategic vendor partnerships to...ClaimsWork at officeLocal areaFlexible hours$23.56 per hour
ZAI is seeking to hire multiple Referral Management (Non-Nurse) Reviewers to support our... ..., the National Capital Region’s premier authority for appointment coordination and referral... ...Management, Authorization/Denials, or Medical Claims Processing/Insurance Referral U.S....ClaimsHourly payContract workFor contractorsWork at office- ..., USA is seeking a Portfolio Manager for a part-time, fixed-term position until 30 June 2028. This role provides strategic leadership for the Authorization Redesign project within the Professional Development team. The ideal candidate will have substantial experience in...SuggestedPart timeFixed term contractFlexible hours
- The Opportunity IntePros Federal is seeking a Strategic Growth Lead to identify, shape, capture, and win strategic contract opportunities across... ...with your Form I‑9 information to confirm that you are authorized to work in the U.S. All qualified applicants will receive consideration...SuggestedContract workWork at officeRemote work
$82k - $118k
The Strategic Engagement Lead serves as the primary coordinator for strategic engagement planning activities supporting the federal client.... ...awarded the associated government contract and receiving authorization to proceed. Key Responsibilities Lead coordination for...Full timeContract workTemporary workWork at officeRemote work- ...surface vessel industrial activities. Public Policy and Strategic Engagement Lead Serving as a trusted advisor to the SIB Program Office in... ...across the executive and legislative branches. Experience authoring or advancing federal legislation, familiarity with the legislative...For contractorsWork at officeFlexible hours
- Public Policy and Strategic Engagement Lead - U.S. Navy Submarine Industrial Base (SIB) Serco is seeking an experienced public policy professional... ...the executive and legislative branches. Experience authoring or advancing federal legislation and familiarity with the...Work at officeWork from home
$169.4k - $279.6k
...of AI and Emerging Technology Architecture, you'll be joining a strategic and collaborative team that is passionate about transforming... ...capabilities and paving the way for best-in-class solutions. As a Lead Architect, you will collaborate with senior Technology and...ClaimsTemporary workWork experience placementLocal area- Gainwell Technologies is seeking a Claims and Finance Lead in Washington, DC. This leadership role focuses on overseeing claims management operations and financial accuracy, leading a team dedicated to timely claim adjudication and process optimization. The ideal candidate...Claims
$146k - $194k
...International Deployment Lead, Middle East Irvine, California, United States; Remote... ...control center. As the world enters an era of strategic competition, Anduril is committed to... ...any questionable or fraudulent outreach claiming to be from Anduril, please report it immediately...ClaimsFull timeWork experience placementImmediate startRemote workWorldwide$25 - $29 per hour
...from home! The Bankruptcy Team Lead will be responsible for... ...processes • May have signing authority to sign bankruptcy documents... ...Motion for Reliefs, Proof of Claims, Transfer of Claims, Reaffirmations... ...your career. Employee referral bonuses so you'll get the opportunity...ClaimsExtra incomeWork experience placementWork from home$152k - $242k
...reinsurance usage, underwriting authority standards, audit process and as part of the referral pathway. The position... ...Services, Legal, Claims, Risk Control and... ...practices.7. Implements strategic objectives, underwriting... ...Property.12. May take lead responsibility for the...ClaimsTemporary workWork experience placementWork at office$152k - $242k
...accordance with the company’s strategic plans. In this officer-level... ...through a blend of underwriting, claims, and/or legal experience. You... ...with enterprise strategy. Leads policy form development,... ...Drives adherence to underwriting authority delegation, audit criteria and...ClaimsWork experience placementWork at office- ..., and cost efficiency. Role Overview The Lead, 340B Growth and Partnerships will be responsible... ...partnerships based on revenue potential, strategic value, and implementation feasibility.... ...required workflows, documentation, claims processes, replenishment procedures, and...ClaimsContract workLocal area
$137.28k - $171.6k
...The Environmental Health & Safety (EHS) Lead develops, implements, and monitors company... ...objectives for the EH&S program(s) to ensure strategic business objectives are met. May also... ...Provide support for worker’s compensation claims including intake, investigation,...ClaimsTemporary workFor contractorsWork experience placementFor subcontractorLocal area- As a BI Lead Analyst, you will be responsible for working closely with many divisions of... ..., Technology, Performance, Growth, and Strategic Payer Partnerships. This position develops... ...experience working with healthcare data (e.g. claims, EHR, clinical) Experience analyzing...Claims
$89k - $117k
Contingent upon contract award. Strategic Communications Lead and Deputy Program Manager serves as the principal strategic communications advisor... ...the associated government contract and receiving authorization to proceed. Key Responsibilities Support development of...Full timeContract workTemporary workFor subcontractorWork at officeLocal areaRemote work$174k - $210k
...pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status. The Strategic Partnerships Lead is responsible for building, managing, and operationalizing Istari's ecosystem of strategic technology partners-...Permanent employmentFor contractorsRemote workHome officeFlexible hours- ...Ivyhill has an immediate need for Referral Management Reviewers (Non-Nurse) for... ...Proactively collaborates with team leads, Product Line Leaders, Appointing Center... ...Management, Referral Management, Authorization/Denials, Medical Claims Processing/Insurance Referral. Qualified...ClaimsTemporary workFor contractorsImmediate start
- ...is currently seeking to hire Referral Management (Non-Nurse) Reviewers... ...’ premier coordinating authority for appointing and referral management... ...referral process to team lead as needed. # Completes and... .../Denials, or Medical Claims Processing/Insurance Referral...ClaimsContract workTemporary workFor contractorsCurrently hiring
- ...A leading technology solutions provider is seeking a Technical Relationship Manager (TRM) to manage customer relationships and assist with the strategic adoption of technology solutions. Candidates should have at least 5 years of experience supporting enterprise customers...Remote work
$285k - $305k
...Strategic Medical Director, PM&R / Post-Acute Care & DME United... ...services. What You'll Do: Lead the vision and evolution of... ...continuumincluding policy, prior authorization, payment accuracy, and... ...authorization data with post-service claims validation, we're creating a...ClaimsRemote workFlexible hours$15.75 - $18.5 per hour
Cardinal Health is looking for a Benefits Eligibility & Authorization Coordinator in Washington, D.C. In this role, you will support the Hold... ...records and entering documentation into systems to facilitate claim processing. You will also be responsible for reviewing...ClaimsHourly pay- ...A leading recruiting firm is seeking a Proposal & Strategic Communications Specialist in Bladensburg, MD. The role involves developing proposals, strategic communication, and collaboration across departments. Ideal candidates have a Bachelor's degree and at least three...Full timeWork at office
$86.3k - $118.7k
...this position the Dental Fraud and Waste Lead for the Humana Dental SIU Team will complete... ...investigation with law enforcement authorities as well as assembles evidence and documentation... ...or auditing experience of dental related claims ~ Knowledge of Medicare regulations ~...ClaimsFull timeTemporary workFor contractorsRemote workWork from homeHome officeMonday to Friday- TryApplyNow is looking for a mid-level Consultant for Strategic Communications & Outreach in Arlington, Virginia. In this role, you will support a Department of Homeland Security client to enhance national infrastructure security through strategic communications and stakeholder...
- Role, Inc. is looking for a Strategic Pursuits Manager in Arlington, Virginia. In this role, you will lead pursuit teams for high-value AI and cloud opportunities, developing and executing strategies to win $50M+ contracts. The ideal candidate should have over 10 years...
$115k - $135k
Datavant is seeking a Strategic Engagement Lead in Washington, DC to drive customer relationships and value realization. You will manage a portfolio, ensuring customer satisfaction and effective program management to foster long-term relationships. Candidates should have...- PowerToFly is seeking a Lead in Supply Chain Analytics to manage strategic projects and support technical direction. In this role, you will develop comprehensive analytics capabilities while mentoring and coaching team members. Work alongside leadership to ensure alignment...Remote work
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