Director, Claims Operations Remote Jobs

Lead the Utilization Management team in ensuring high-quality healthcare delivery. Oversee provider engagement and compliance with standards, fostering collaboration with physicians and hospitals to e...

Drive product innovation by designing and implementing systems that enhance operations. Collaborate across teams to automate workflows, analyze data for decision-making, and create impactful solutions...

Pioneer government pricing and GTN forecasting operations, ensuring compliance and accuracy while partnering across functions to drive commercialization. Lead operational excellence and regulatory upd...

Shape strategic cost recovery initiatives while collaborating with health plans and vendors to optimize performance and achieve financial targets. Drive process improvements and present actionable ins...

Elevate your career by managing accounts, ensuring retention, and leading a dedicated team. Utilize your expertise to resolve complex issues while delivering exceptional customer service in a collabor...

Oversee the end-to-end Medicare Advantage product experience, driving member engagement and care delivery. Collaborate with cross-functional teams to create scalable solutions that meet unique Medicar...

Join a strategic team to enhance data insights and operational efficiency. Leverage your expertise in cloud architectures and analytics while guiding teams in developing modern data solutions for info...

Unlock potential by supporting the Medical Stop Loss team with RFP management, administrative tasks, and customer relations. Collaborate with sales and ensure compliance while driving high customer sa...

Advance organizational effectiveness by overseeing strategic planning and implementation of managed care programs. Drive negotiation and analysis of contracts, ensuring compliance, growth, and marketi...

Empower your career by leading a dynamic team in achieving impactful actuarial goals, enhancing pricing and forecasting strategies while ensuring compliance and personal development in a collaborative...

Join a dynamic team to enhance client experiences through effective system design, leveraging Salesforce and Zoom solutions. Drive operational excellence by optimizing workflows and collaborating with...

Drive impactful Phase IV and observational research initiatives by partnering with biopharmaceutical sponsors. Leverage deep scientific expertise to create tailored study designs, foster relationships...

Join a team that's driving a robust data privacy program across the US. You'll ensure compliance, champion privacy awareness, and manage risks in a dynamic regulatory landscape, collaborating with var...

Help us drive growth and engagement in provider partnerships. Lead strategy, operations, and relationship management for our provider relations team, ensuring alignment with organizational goals and e...

Unlock insights as you bridge business needs with technology, enhancing commercial insurance solutions. Collaborate, analyze, and support projects to drive quality, ensure alignment, and facilitate co...

Champion growth by leading a team that delivers analytics and reporting, enhancing Customer Success performance through data-driven insights and operational metrics to support strategic decision-makin...

Join a team that drives growth by leading operational improvements and optimizing processes across multiple US sites. Your expertise will enhance efficiency, productivity, and quality, ensuring excell...

Take ownership of financial operations, budgeting, and data governance. You'll lead reporting, compliance, and analytics to guide strategic decisions while mentoring a talented finance team for optima...

Champion profitable business development as the senior underwriter, driving growth, portfolio management, and agency relationships while ensuring compliance and excellence in commercial surety underwr...

Lead the strategic management and growth of a regional Commercial Surety portfolio. Drive profitable underwriting practices while cultivating strong relationships with brokers and agencies to enhance...

Pioneer innovative clinical pharmacy strategies to enhance Medicare Stars performance. Leverage deep expertise in pharmacy quality, influence cross-functional teams, and drive measurable outcomes to i...

Optimize New Jersey workers' compensation claims by investigating, negotiating, and driving effective resolutions while ensuring compliance with regulations and laws in a remote, fast-paced environmen...

Lead the charge in managing a dynamic sales team within the SaaS sector, ensuring alignment with company goals and a robust sales pipeline while coaching and developing high-performing sales professio...

Engage with a diverse commercial client portfolio by managing accounts, enhancing retention, and driving new business initiatives. Utilize expertise in transportation and trucking to provide outstandi...

Transform marketing operations by enhancing CRM systems and automation, ensuring alignment between teams to optimize family and provider engagement throughout the application process while leveraging...