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
$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...ClaimsFull timeWork experience placementWork at office- 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...SuggestedLocal areaRemote workFlexible hours
- ...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...ClaimsFull time
$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...ClaimsRemote jobTemporary workWork experience placementWork at office$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...ClaimsWork experience placementRemote workFlexible hours$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...ClaimsFull timeTemporary workWork experience placementWork at officeLocal areaRemote workFlexible hours2 days per week- ...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...ClaimsTemporary workWork at officeRemote workWork from home
- ...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 roleWork at office
$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...ClaimsTraineeshipLocal area$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...ClaimsContract workSecond jobLocal area- ...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:...ClaimsContract workWork at office
- ...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....ClaimsTemporary workWork experience placementCurrently hiringWork from homeFlexible hoursShift work
$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...ClaimsHourly payTemporary workInterim roleRemote workFlexible hours- ...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,...ClaimsFull timeNight shift
- ...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
$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...ClaimsTemporary workWork at officeRemote workWork from home- ...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...ClaimsFull timeWork at officeRemote work
$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...ClaimsTemporary workLocal areaFlexible hours- 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...ClaimsRemote job
$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...ClaimsFull timeTemporary workWork at officeRemote work- 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...ClaimsRemote job
$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...ClaimsContract workWork at office- 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...ClaimsFull time
$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...ClaimsRemote jobHome office- ...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
$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...ClaimsFull timeTemporary workRemote workWork from home- ...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 timeTraineeshipLocal area
- 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
- ...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...ClaimsTemporary workWork at officeRemote workWork from home
$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...ClaimsTemporary workWork at officeLocal areaRemote work
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