Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Managing Director, Strategic Claims Oversight, Healthcare Severity

Confidential

Managing Director, Strategic Claims Oversight, Healthcare Severity

About the Company

Top provider of insurance products & related services

Industry
Insurance

Type
Public Company

Founded
1897

Employees
5001-10,000

Categories

  • Insurance
  • B2B
  • Enterprise
  • Consulting & Professional Services
  • Agents and Marketers
  • Casualty
  • Finance
  • Multi-Line
  • Property
  • Property and Casualty Insurance
  • Financial Services
  • Information Technology
  • Property Management
  • Real Estate
  • Risk Management

Specialties

  • commercial insurance
  • specialty insurance
  • construction
  • financial institutions
  • healthcare
  • manufacturing
  • professional services
  • real estate
  • small business
  • technology
  • retail
  • and wholesale distribution

Business Classifications

  • B2B
  • Enterprise

About the Role

The Company is seeking a Managing Director for Strategic Claims Oversight in Healthcare Severity. The successful candidate will lead a team that is responsible for the direct handling and oversight of the highest exposure claims in the healthcare sector. This role is pivotal in ensuring the effective execution of claims handling practices, driving operational initiatives, and leading continuous improvement efforts. The Managing Director will be accountable for the overall quality, customer service delivery, and productivity of the team, and will be expected to have a clear vision for their career, with the support of the company's leadership to help them achieve their professional goals. Key responsibilities for the Managing Director include leading and directing the work activities of the Severity Team, overseeing complex claim investigations, and determining claim strategies. The role also involves developing and maintaining collaborative relationships with internal and external business partners, and ensuring the team is in compliance with best practices. The ideal candidate will have a senior-level knowledge of claim and litigation management, excellent communication, negotiation, and facilitation skills, and the ability to manage ambiguous situations. A Bachelor's degree is required, with a JD preferred, and a minimum of ten years of claims or legal experience is typical, with a proven track record of positive results. The candidate should be value-driven, with a sense of urgency to advance the organization's priorities, and a strong ability to coach, mentor, and develop subordinate staff.

Hiring Manager Title
AVP

Functions

  • Legal
  • Operations
Confidential
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Managing Director, Strategic Claims Oversight, Healthcare Severity in New York, NY vacancy
  • $97k - $189k

     ...employees are used to their fullest potential. The Managing Director Strategic Claim Oversight leads the Severity & Excess Accounts team that both directly handles and oversees the highest exposure claims in Healthcare. Ensures the effective execution of claims handling... 
    Claims
    Full time
    Work experience placement
    Work at office

    CNA Financial

    New York, NY
    5 days ago
  • Director, Global Executive & Strategic Recruiting Location: Remote, United States or Everett...  ..., HR leaders, and hiring managers to define leadership...  ...build environments, and healthcare. We are a global industrial...  ...insurance programs, and several programs that provide for... 
    Suggested
    Local area
    Remote work
    Flexible hours

    Fortive

    New York, NY
    19 hours ago
  •  ...pathways to improve healthcare delivery for...  ...and precision in claims administration. We...  ...are looking for a Director of Health Plan Administration...  ...to serve as the strategic lead for our...  ...accuracy, managing stop-loss reimbursements...  ...the high-level oversight required for... 
    Claims
    Full time

    Covet Health

    New York, NY
    2 days ago
  • $69.45k - $135.42k

    Molina Healthcare of Kentucky is hiring a Program Manager, Health Plan Payment Integrity (Claims & Recovery). This position is remote. Highly...  ...subject matter expertise for oversight, production, and...  ...respond to provider inquiries. Strategic Business Analysis Uses a... 
    Claims
    Remote job
    Temporary work
    Work experience placement
    Work at office

    Molina Healthcare, Inc.

    New York, NY
    2 days ago
  • $65k - $70k

     ...serving hospitals and other healthcare facilities across the...  ...daily Revenue Cycle Management operations, including...  ...follow-up, and claim resolution to support...  ...management, and productivity oversight. Knowledge of accounts...  ...may vary based on several factors including but... 
    Claims
    Work experience placement
    Remote work
    Flexible hours

    Radiology Partners, Inc.

    New York, NY
    18 hours ago
  • $70k - $80k

     ...to apply for the Manager, Integrated (Media...  ...and in the healthcare industry isn’t just...  ...requiring minimal oversight to do your best work...  ...sources claiming to be connected to...  ...Solutions Manager, Strategic Accounts, Marketing...  ...Temporary Associate Director, Cross-Channel Planning... 
    Claims
    Full time
    Temporary work
    Work experience placement
    Work at office
    Local area
    Remote work
    Flexible hours
    2 days per week

    Real Chemistry

    New York, NY
    3 days ago
  •  ...pertinent to processing claim. Sort, organize and...  ...specific special handling. Oversight of Cases: Monitor,...  ...working in a healthcare (medical office, insurance...  ...environment. Ability to manage multiple tasks and...  ...compensation will depend on several factors including the... 
    Claims
    Temporary work
    Work at office
    Remote work
    Work from home

    Dane Street

    New York, NY
    1 day ago
  •  ...Managing Director, AI Strategy & Readiness About the Company Provider of specialized finance solutions for businesses & individuals...  ...Risk Analysis Real Estate Manufacturing Banking Healthcare Life Sciences CPA Services Tax Services Financial... 
    Interim role
    Work at office

    Confidential

    New York, NY
    5 days ago
  • $132k - $198.07k

     ...monthly as needed. The Product Manager is responsible for supporting data...  ...Experience in or understanding of healthcare or health data (e.g., EHRs, claims, clinical quality measures, population...  ...among the country’s best in several pediatric specialties. The Icahn School... 
    Claims
    Traineeship
    Local area

    Mount Sinai Health System

    New York, NY
    7 days ago
  • $155k - $190k

     ...compared to 32 for typical healthcare organizations....  ...About The Role As our Director of Strategic Operations, you'll...  ...credentialing, and more have to manage a suite of tasks —...  ...signature: buildout oversight, furniture, decor,...  ...with patients seen, claims paid, and data... 
    Claims
    Contract work
    Second job
    Local area

    Greenbrook Medical

    New York, NY
    1 day ago
  •  ...executive responsible for the strategic leadership, integration,...  ...The CAO provides enterprise oversight of Claims, Provider Network...  ...Operations, Provider Data Management, Vendor Management, Payment...  ...Demonstrated leadership experience in several of the following areas:... 
    Claims
    Contract work
    Work at office

    MetroPlusHealth

    New York, NY
    1 day ago
  •  ...BPM services with decades of healthcare domain expertise to help...  ...offerings for clinical, case management, member engagement, provider...  ...solutions, payment integrity, claims cost containment, and analytics...  ...and timelines, and maintain oversight of the work and outcomes.... 
    Claims
    Temporary work
    Work experience placement
    Currently hiring
    Work from home
    Flexible hours
    Shift work

    Sagility

    New York, NY
    2 days ago
  • $28.85 - $35 per hour

     ...Specialist for a fast-growing healthcare revenue recovery organization...  ...denied and underpaid insurance claims through disciplined, payer-specific workflows. You will manage assigned denial queues, submit...  ...based on performance in the first several months. Converted employees... 
    Claims
    Hourly pay
    Temporary work
    Interim role
    Remote work
    Flexible hours

    Scion Staffing

    New York, NY
    1 day ago
  •  ...residential wellness and healthcare infrastructure, we...  ...is seeking a strategic, financially sophisticated...  ...company's enterprise risk management and insurance...  ..., captive insurance, claims oversight, and executive-level...  ...professional liability, directors and officers, cyber,... 
    Claims
    Full time
    Night shift

    Welltower

    New York, NY
    4 days ago
  •  ...seeks a talented, committed leader to serve as Managing Director. This role combines day-to-day operational leadership with strategic, organization-wide planning across...  ...long-term impact while maintaining day-to-day oversight. The Managing Director reports to the Executive... 
    Remote job

    Job Post

    New York, NY
    2 days ago
  • $45k - $70k

     ...Overview The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that...  ...physicians, and the Medical Director. Additional Duties May provide oversight to the work of the team...  ...process over 200,000 insurance claims annually for leading... 
    Claims
    Temporary work
    Work at office
    Remote work
    Work from home

    Dane Street

    New York, NY
    2 days ago
  •  ...This role combines patient communication, healthcare administration, prior authorizations,...  ...proactive, dependable, and comfortable managing several priorities independently in a remote...  ...verification. Assist with referral management and claims-related communication. Maintain... 
    Claims
    Full time
    Work at office
    Remote work

    Wow Remote Teams

    New York, NY
    4 days ago
  • $209.6k - $313.38k

     ...marketed assets. The Medical Director, Global Medical...  ...developing and executing strategic medical plans and...  ...relationships with key external healthcare providers The Medical...  ...for execution. Managing external providers, create...  ...fee, even if claimed you will be reimbursed... 
    Claims
    Temporary work
    Local area
    Flexible hours

    Otsuka Pharmaceutical Co., Ltd.

    New York, NY
    2 days ago
  • Molina Healthcare of Kentucky is seeking a Program Manager, Health Plan Payment Integrity (Claims & Recovery) to lead PI efforts remotely. You will oversee SAIs, ensure regulatory compliance, and collaborate with CMS/state teams to optimize pre-pay edits, post-payment... 
    Claims
    Remote job

    Molina Healthcare, Inc.

    New York, NY
    2 days ago
  • $69.45k - $135.42k

     ...of a partner company, which manages all applications and next steps...  ...Plan Payment Integrity (Claims & Recovery) based in the United...  ...opportunity for an experienced healthcare professional to lead payment...  ...business priorities. Provide strategic recommendations and serve as... 
    Claims
    Full time
    Temporary work
    Work at office
    Remote work

    Jobgether

    New York, NY
    2 days ago
  • Molina Healthcare of Kentucky is hiring a Program Manager, Health Plan Payment Integrity (Claims & Recovery). This remote role requires leading PI initiatives, ensuring CMS and state regulatory compliance, and driving cost containment. Strong knowledge of Medicaid, Medicare... 
    Claims
    Remote job

    Molina Healthcare, Inc.

    New York, NY
    2 days ago
  • $150k - $175k

     ...dedicated to making quality mental healthcare accessible to every young...  ..., chasing down a denied claim. Nobody at Handspring is above...  ...before handing them off. Strategic Analysis: Build the analysis...  ...meeting. Help establish and manage the processes for setting company... 
    Claims
    Contract work
    Work at office

    Handspring Health

    New York, NY
    5 hours ago
  • A healthcare solutions provider seeks a Claims Manager to oversee liability claims. Responsibilities include managing claims, supporting providers, and collaborating with defense counsel. The ideal candidate has a Bachelor's degree and three years of experience in a law... 
    Claims
    Full time

    US Acute Care Solutions

    New York, NY
    2 days ago
  • $54.24k

    What This Role Covers A denied claim sitting unresolved for weeks...  ...\'d be working closely with healthcare providers and internal teams...  .... Your Core Responsibilities Managing health insurance claims from...  ...without feeling like constant oversight. Billing work touches many other... 
    Claims
    Remote job
    Home office

    Naukri Mitra

    New York, NY
    2 days ago
  •  ...workers’ compensation & risk management solutions Industry...  ...Relations Consulting Healthcare Savings & Investing Finance...  ...ancillary benefit management ~ claims management ~ provider...  ...Strategy to set and execute the strategic direction for its liability... 
    Claims

    Confidential

    New York, NY
    5 days ago
  • $85 per hour

     ...missing pertinent to processing claim. • Sort, organize and create...  ...with the case assignment. Oversight of Cases: • Monitor, process...  ...EXPERIENCE: Business experience in a healthcare and/or insurance setting is...  ...to apply critical thinking, manage time efficiently and meet... 
    Claims
    Full time
    Temporary work
    Remote work
    Work from home

    Dane Street

    New York, NY
    2 days ago
  •  ...psychiatry programs by Becker's Healthcare. The Inpatient Psychiatry...  ...partnership with the Medical Director of Acute Care and Vice Chair...  ...Provides clinical oversight and supervision for psychiatry...  ...among the country's best in several pediatric specialties. The Icahn... 
    Full time
    Traineeship
    Local area

    Mount Sinai Hospital

    New York, NY
    1 day ago
  • EnableComp LLC helps hospitals recover complex claims and revenue loss through its AI-driven platform, serving over 1,000 hospitals and recovering billions annually. We are recognized as a Top Workplace with core values centered on integrity, client success, and empowered... 
    Claims

    EnableComp LLC

    New York, NY
    3 days ago
  •  ...the customer, reviewer, and management to ensure a completed report...  ...Additional Duties May provide oversight to the work of the team...  ...EXPERIENCE: Business experience in a healthcare and/or insurance setting is...  ...over 200,000 insurance claims annually for leading national... 
    Claims
    Temporary work
    Work at office
    Remote work
    Work from home

    Dane Street

    New York, NY
    19 hours ago
  • $46.9k - $89.85k

     ...technology-enabled revenue cycle management solutions for health systems...  ...healthy. We recognize that healthcare requires a human touch, and...  ...with problematic claims and questions regarding processes...  ...Integrity. This position will have oversight of all Human Resource... 
    Claims
    Temporary work
    Work at office
    Local area
    Remote work

    Ensemble Health Partners

    New York, NY
    5 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Managing Director, Strategic Claims Oversight, Healthcare Severity. Be the first to apply!