Senior Director, AI-Powered Claims Pricing
Zelis
Zelis seeks a Senior Director of Pricing Solutions to lead strategic initiatives improving the performance, efficiency, scalability, and future readiness of the Claims Pricing & Revenue organization. This role collaborates with leadership to turn priorities into actionable roadmaps, ensure measurable outcomes, and drive continuous improvement across pricing, repricing, and negotiations. Initially an senior IC with potential to grow into people leadership, the role emphasizes AI, automation, #J-18808-Ljbffr Zelis
$140k - $190k
...AI Engineering Role At Coaction, we're a unique mix of leaders, achievers, thinkers... ...we design, build, deploy, and operate AI-powered solutions safely and responsibly. The ideal... ...workflows (e.g., submissions, endorsements, claims documentation) using enterprise data...SeniorClaimsWork experience placement- ...Location - Florham Park, NJ (Remote) Pharmacy Claims & PBM Domain Testing NCPDP D.0 / F6... ...Validation Claim Adjudication, Eligibility, COB, Pricing & Reject Messaging Test Planning, Test... ...Waterfall & Cross-functional Collaboration AI Tools for Test Automation Resource...SeniorClaimsRemote work
- ...Director, Government Pricing Location: Morristown, New Jersey, United States Work Model: Hybrid... ...presentation abilities, with experience engaging senior leadership. Advanced proficiency... ...with Data Analytics or BI Tools (Power BI, Tableau, SQL - specify proficiency...SuggestedContract workH1bWork at officeRemote workRelocation
$160k - $200k
...with us on LinkedIn or Twitter Position Summary The Senior Manager of US Benefits will lead the strategic design, financial... ...: Partner with consultants and actuaries to analyze monthly claims data, evaluate stop-loss coverage limits, and establish annual premium...SeniorClaimsContract workTemporary workWorldwide$128k - $245k
...can learn, grow, and thrive. At Verizon, we power and empower how people live, work and play... ...acumen to build and launch advanced AI products and enterprise services. The ideal... ...economics (GPU/token costs), AI services, prices and GTM strategies. Hands-on familiarity with...SeniorFull timeTemporary workPart timeWork experience placementWork at officeWork from homeShift work3 days per week- ...years hands-on experience with Strategy (formerly MicroStrategy), Microsoft Power BI or similar product. Working knowledge of insurance source systems such as Guidewire (Policy, Billing, Claims), Genius, and SAP. Strong SQL skills and experience querying enterprise data...Claims
$105k - $133k
...measurable results for clients. At Zelis, AI is woven into the fabric of how we work. Every... ...shape who you are. Position Overview The Senior Content Ideation Specialist role is... ...Validation content management under the Expert Claim Review (ECR) suite of solutions. The...SeniorClaimsFull timeWork at officeLocal areaRemote workFlexible hours$131.2k - $174.98k
...next? Role Overview BI and AI capabilities are evolving... ...sidelines. We are seeking a US-based Senior BI Consultant who can operate... ...(minimum two, preferably Power BI and Tableau), plus working... ...pharma data sources such as CRM, claims, sales, call activity, HCP / HCO...ClaimsHourly payFull timeShift work- ...Sompo is seeking a Sr. Casualty Claims Counsel to join the US Casualty Claims team. The role supports primary and excess casualty claims with emphasis on coverage, emerging risk, and long-term exposure. JD required with 5+ years in insurance claims; CPCU or similar designations...SeniorClaimsWork at office
- ...Summary The Associate Director, Commercial Analytics,... ..., focusing on patient claims analytics, brand analytics... ...with clients’ senior stakeholders. Act as the... ...service offerings and AI/ML applications to innovate... ...software such as Tableau or Power BI. ~ Technical...ClaimsRemote work
- Technical Director, Price Optimization This role sets the technical direction... ...data across offerings. As a senior technical leader, you will... ...hands-on leadership in applying AI and AI-native software... ...design across pricing, payments, claims, reimbursement, provider-payer...Claims
$80k - $105k
...with You. Experience the Transformative Power of Withum Plus You - that’s the Power in... ...This Industrial and Consumer Products Audit Senior role can be based out of our East... ...carefully verify the email domain of anyone claiming to represent Withum and be cautious of communications...SeniorClaimsWork at officeLocal area- Accident & Health - Senior Financial AnalystThe Accident and Health... ...closely with Actuarial, Accounting, Claims Operations, and enterprise... ...that support reserving and pricing decisions.Partner with enterprise... ...Excel and data tools (e.g., Power BI).Experience working with insurance...SeniorClaims
- Job Title: Associate Director, Brand Analytics - Systemic Mastocytosis... ...levers (e.g., application of AI/ML models to understand patient... ...questions. Patient‑level claims data experience (IQVIA, Komodo... ...business intelligence tools (e.g., Power BI, Tableau, Qlik, or...ClaimsWork at officeLocal areaWorldwide
$175.73k - $292.88k
...customers through innovative strategies, advanced analytics, Generative AI, transformative technologies, and creative design. We can enhance... ...for this role ends on December 31, 2026.Work you'll doAs a Senior Manager, on the Technical Transformation team, you will be...SeniorLocal area$207k - $275k
CoreWeave is The Essential Cloud for AI. Built for pioneers by... ...supports the infrastructure that powers the AI revolution—working... ...position reports directly to the Director of Cloud Platform Support, is... ...complex projects with visibility to senior stakeholdersExpert leadership...SeniorPermanent employmentFull timeTemporary workCasual workWork at officeFlexible hours- Arch Capital Group Ltd. is seeking a Senior Claims Examiner, Casualty, for its Middle Market Casualty Team within Arch Insurance Group. This role handles complex general liability and related excess/umbrella claims nationwide. Ideal candidates will have strong negotiation...SeniorClaims
- Arch Insurance Group Inc. is seeking a Claims professional to manage Lawyers Professional Liability claims across jurisdictions in the United States. This role emphasizes developing timely resolution strategies, addressing coverage issues, and coordinating with underwriters...SeniorClaims
- Atlantic Health in Morristown, NJ seeks an Employment Counsel (claims manager) to lead employment-related claims, agency matters, and... ...medical centers and affiliates. The role requires managing assigned directors & officers and EPL claims, reviewing demand letters and...SeniorClaims
- Arch Insurance Group Inc. is seeking a seasoned attorney/claims executive to lead strategy and resolution of its most complex, high-exposure... ...Reporting to the Chief Technical Claim Officer, you will advise senior leadership, drive litigation management, and partner with Claims...SeniorClaims
- ...Senior Counsel – Sales Operations The Senior Counsel – Sales Operations provides strategic... ...sales teams on commercial contracts, pricing programs, promotions, and customer-facing... ...advertising, promotional materials, and product claims. Support corporate governance,...SeniorClaims
$60k - $97k
LE003 Coaction Specialty Management Company, Inc. is seeking a Senior Claims Examiner to join the Morristown, NJ office. The role involves expert handling of complex claims, ensuring compliance with best practices, and providing excellent customer service to clients. Candidates...SeniorClaimsWork at office$108k - $145.07k
...Senior Cost Manager As a Senior Cost Manager at Linesight, you will work with highly... ...accounts, including the handling of any claims to ensure the client gets best value from... ...With Linesight, you can truly discover the power of team! Diversity, inclusion and accessibility...SeniorClaimsContract work- ...experienced in-house Counsel to lead internal positions on drug pricing and government programs, including 340B, PBM reform, MFN, and... ...with Law Division, monitoring regulatory changes, and advising senior leaders while shaping cross-functional legal and policy strategy...Senior
- ...to lead policy, strategy and litigation for market access. The role partners with senior leaders to define internal positions, shape litigation and advocacy, and advance Sanofi’s pricing and access initiatives on a national scale. The successful candidate will bring at...Senior
- ...Opportunity: Role Summary We are seeking a highly motivated and talented Director, Analytics to join our dynamic team. This individual will be... ...sources. Familiarity with syndicated data sources (eg, IQVIA, claims data, etc). Skills Expertise with BI platforms (Tableau, Data...ClaimsWork at office
- Zelis is modernizing the healthcare financial experience. The Senior Content Ideation Specialist will develop and deliver content for Itemized Bill Review and DRG Validation within the Expert Claim Review suite, sourcing from ICD-10, AHA, AMA, CPT, CMS and clinical research...SeniorClaimsRemote jobWork at office
$125k - $175k
Senior Claims SpecialistPosition Summary: The Senior Claims Specialist is responsible for coverage analysis, investigation, negotiation, and the resolution of general liability matters across the U.S., with a particular focus on New York construction claims. The Senior...SeniorClaims$155k - $182k
...building bench strength.As a trusted HRBP to senior leaders in your assigned client groups,... ..., build leadership assessment rigor for Director-and-above hiring decisions.Diagnose team... ...a recruitment-related email message claiming to be from Zoetis that does not come from...SeniorClaimsFull timeTemporary workLocal area$188k - $315.8k
...Dun & Bradstreet, we believe data has the power to create a better tomorrow. As a global... ...at dnb.com/careers . The Senior Director, People Business Partner (HRBP) serves as... ...Microsoft 365 Copilot and other approved AI tools to accelerate analysis, synthesize...SeniorFull timeWork at officeWorldwideShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Director, AI-Powered Claims Pricing. Be the first to apply!
- director of mental health Convent Station, NJ
- lab director Convent Station, NJ
- director of sustainability Convent Station, NJ
- director Convent Station, NJ
- director talent acquisition Convent Station, NJ
- director of radiology Convent Station, NJ
- director of inventory management Convent Station, NJ
- dance director Convent Station, NJ
- director of public safety Convent Station, NJ
- director of innovation Convent Station, NJ


