MGA Claims Program Lead — TPA & Data-Driven Excellence
Travelers Canada
Travelers Canada in Boston is looking for a qualified candidate to manage claims and ensure excellence in processes. Responsibilities include guiding TPA partners, monitoring KPIs, and conducting audits while having the opportunity to provide expert insights on claims. The ideal candidate should possess relevant professional designations and at least 5 years of experience in claims or risk management, specifically with Commercial Lines General Liability. This role supports a hybrid working model and offers comprehensive benefits. #J-18808-Ljbffr Travelers Canada
- Simply Business is seeking a Claims Program Manager in Boston, MA. This role focuses on ensuring claims integrity and driving profitability... ...program management and oversight of Third-Party Administrator (TPA) programs. The ideal candidate will have a Bachelor’s Degree...Claims
$85.6k - $141.2k
...Responsibilities Guide TPA partners as the... ...to ensure claims excellence and accurate... ...claims. Drive data intelligence by... ...stakeholders to lead roundtable discussions... ...a data‑driven mindset and analytical... ...with TPA, MGA or delegated... ...company’s bonus program. Participation...DataClaimsTemporary workWork at office- ...Humana is seeking a Value-Based Program Lead to oversee and support Value-Based Programs across... ...business reviews, analyze market data, and consult on VBP strategy to ensure compliance... .... The position is remote and requires excellent analytical and communication skills. #J-...DataContract workRemote work
$175k - $195k
A leading biotechnology company seeks a Clinical Programs Director to drive data-driven solutions in CRM Analytics. This role involves leadership on AI tools and overseeing the development of analytics capabilities to support critical initiatives. Candidates should possess...DataRemote work$68.8k - $94k
A leading public sector solutions provider is seeking a TPA Claiming Lead in Boston, MA. This role involves overseeing claims management within the School-Based Services... ...with a strong background in claims analysis, data management, and project management. The position...DataClaimsRemote work$297.59k - $360.6k
...benefits, services and programs that provide our... ...will be responsible for leading a portion of the Pumitamig... ...debate and rapid, data-driven decision making; and (... ...of clinical data into claims and considerations for... ...with disabilities can excel through a transparent...DataClaimsHourly payFull timeTemporary workPart timeFor contractorsSummer workLive inWork at officeLocal areaRemote workFlexible hoursShift work$125k - $150k
...Technologies (FRT) is a leading technology-based... ...identify eligibility, file claims, and recover funds... ...integrated marketing programs that generate demand,... ...points, and implement data-driven optimizations. Leverage... ...is a plus ~ Excellent Communicator, both verbal...DataClaimsTemporary workWork at office2 days per week3 days per week$91.4k - $187k
...Oracle Health Data Intelligence (HDI)... ...contribute to AI-driven projects by applying... ...based improvement programs. Hands-on experience... ...eligibility, and claims data, to drive... .../ML solutions. Lead annotation review... ...and annotations. Excellent communication and...DataClaimsTemporary workFlexible hours- ...transform diverse data into a unified fabric... ...Engage with leading customers, participating... ...communicating program/project status, issues... ..., preferably with claims and clinical data... ...for You to Have Excellent presentation and communication... ...part of a mission driven company that is...DataClaimsRemote jobContract workFlexible hours
$154.4k - $242.55k
...At Takeda, we are driven by our purpose:... ...group strategy. Lead specific Global Insurance Programs and the end‑to‑end claims lifecycle. Ensure... ...annual, underwriting data gathering and... ...Serve as a Centre of Excellence on insurance and... ...claims with TPA’s and claims handlers...DataClaimsMinimum wageFull timeContract workTemporary workWork at officeLocal areaImmediate start$177k - $278.08k
...) organization as the Lead of Immunology Analytics... ...PsA. This role drives data‑driven decision making across... ...like patient‑level claims, sales, patient access... ...strategy into action; excellent analytical skills and... ...in analytics tools and programming languages (e.g., Python...DataClaimsMinimum wageFull timeTemporary workLocal area$142.3k - $195.7k
...Lead Solutions Architect Humana is looking... ...the integration of data with external... ...~8+ years of large program delivery experience... ...platforms and event driven architecture around... ...member, provider, claims and clinical data... ...Incentive Plan ~401K - Excellent company match ~ Well...DataClaimsBi-weekly payFull timeTemporary workWork at officeWork from homeHome office$177k - $278.08k
...payer decision outcomes. Lead cross‑functional... ...innovative digital, data science, and AI‑driven health economics and... ...strategic thought leadership programs. Advance Takeda’s... ...of innovation and excellence in health economics.... ...large databases (e.g., claims data, electronic health...DataClaimsMinimum wageFull timeContract workTemporary workLocal areaRemote workWorldwide$210k - $303.33k
...Strategy and Cross-Organization Excellence Lead Location: Cambridge, MA... ...About Sanofi We’re an R&D-driven, AI-powered biopharma company... ..., Specialty Care, providing data-driven insights, scenario analyses... ...business transformation, or program management, with demonstrated...DataImmediate startShift work$72k - $91k
...Product Management Community is seeking a Benefits Analyst based in Boston, MA. This role oversees CarGurus' North America Benefits programs and requires 5+ years of U.S. benefits experience. Responsibilities include managing leave and accommodation cases, providing...Data$178.5k - $257.83k
...Job Title: Sr. AI Driven Innovations Lead Location: Morristown, NJ About... ...Lead within Clinical Data & AI Processing organization... ...analyses, driving operational excellence across the organization.... ...data management, statistical programming, biostatistics) and technical...DataTemporary workWork experience placementFlexible hours- ...NeighborHealth's 340B pharmacy program. This entails a... ..., including data submission, audit... ...pricing eligibility. Lead internal 340B audit... .... Validate claims data submitted through... .... Validate TPA rules/logic are current... ...program components. Excellent attention to detail...DataClaimsContract workFixed term contractWork experience placement
$136.4k - $253.2k
...role is in Analytical Data Science, a core function... ...to generate data-driven insights, identify opportunities... ...is recognized as a leading hub for top industry... ...and align statistical programming practices across both... ...culture of technical excellence, and ensuring alignment...DataLocal areaRelocation package- ...AI Innovation Lead We are seeking an AI Innovation... ...Lead (Managing Lead Data Scientist) to spearhead... ...from underwriting and claims to customer service.... ...culture of innovation and excellence. Communicate insights... ...oriented, and business impact-driven. Preferred...DataClaimsRemote workRelocation package
- ...Manager, Portfolio Program Management for a... ...diagnostic (CDx) claims to existing products... ...and resources Leads internal and external... ...SAFE TEST-DRIVEN DEVELOPMENT INVERSION... ...-do attitude Excellent communication and... ...privacy of patient data Working...DataClaimsContract workWork at office
$341.36k - $413.65k
...benefits, services and programs that provide our employees... ...: The Global Program Lead (GPL) will serve as the... ...evolution as emerging data and competitive insights... ...of clinical data into claims and considerations for... ...with disabilities can excel through a transparent recruitment...DataClaimsHourly payFull timeTemporary workPart timeFor contractorsSummer workLive inWork at officeLocal areaRemote workFlexible hoursShift work$120k - $155k
...Reporting to: Claims Director, Property... ...follows an 'all roads lead to Hiscox' philosophy... ...The role requires excellent technical claims... ...implementation of data to drive key... ...Travel Reimbursement Programs ~ Annual reimbursement... ..., and values-driven culture ~ Modern...DataClaimsPermanent employmentTemporary workWork at office$185k
...looking for a Senior Healthcare Data Analyst to help customers... ...operationalize complex clinical and claims data at scale. What's on... ...-impact role within a mission-driven healthcare technology business... ...problem-solving ability ~ Excellent communication skills with the...DataClaimsRemote work- ...Summary The Senior Scrum Lead at Coverys plays a key... ...policy, billing, claims, and underwriting systems... ...insurance space (including data privacy and audit... ...to compliance or audit‑driven environments in insurance... ...communication. Delivery Excellence and Execution Discipline...DataClaims
$130k - $150k
...creativity, and AI-driven insights,... ...are committed to excellence for both our clients... ...health. You will lead client engagements... ...to dive into the data. You are highly... ...together a benefits program designed to give you... ...unverified sources claiming to be connected to...DataClaimsWork experience placementFor subcontractorWork at officeLocal areaRemote workFlexible hours2 days per week$62.5k - $91k
...Inpatient Lead Coder Assigns appropriate codes... ...reimbursement. Abstracts required data to input into the... ...at in-service programs, conferences, workshops... ...Cycle Analysts in working claims in scrubber to clear for... ...techniques required. Excellent organizational skills,...DataClaims$249.97k - $388.13k
...Global Value Evidence Lead, is a strategic leader... ...culture of scientific excellence, and ensuring strategic... ...evidence generation and data use. Qualifications:... ...holidays, and paid leave programs as well as other company... ...fee, even if claimed you will be reimbursed,...DataClaimsTemporary workLocal areaFlexible hours$124k - $155k
...Principal Technical Program Manager CMT is seeking... ...to independently lead broad cross-organization... ...simplicity, and operational excellence. CMT is looking for... ...with ML- or data-driven product development, including... ..., and streamline claims. Headquartered in Cambridge...DataClaimsTemporary workSummer workWork from homeWorldwideFlexible hours$203.21k - $304.82k
...Enterprise AI engine - uniting data foundations, AI... ...around an AI Centre of Excellence, an AI Frontier research... ...pressure‑test partner claims. Experience translating... ...fast enough to lead the conversation inside... ...based long‑term incentive program. Benefits offered include...DataClaimsTemporary workWork at officeFlexible hours3 days per week$298k - $409.8k
...and reviews health claims, requiring a solid... ...execution Lead the Future of Care... ...strategic, outcomes-driven clinical leadership... ...outcomes Operational Excellence Improve... ...teams Clinical program leaders Operations... ...environments ~ Data-driven mindset with...DataClaimsFull timeTemporary workRemote workShift work
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