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92 fresh jobs found

Senior Claims Quality Control Analyst
Remote

Database languages Total quality management Healthcare Claims Models Business Insights Healthcare operations Lean Six Sigma Workflow Management Technology Platform +32

Senior Full Time

USD 65K+

Specialist, Contract Underwriting - E&S/Specialty
Arizona - Scottsdale, 18700 North Hayden Road

Reinsurance Placement Loss History Analysis Risk selection Insurance Law Claims review Training and Mentoring Loss control Insurance Solutions Business knowledge +26

USD 72K+

Manager, Pharmacy Policy
Remote

Pharmacy Policy Quality care Clinical Policy Clinical evidence MCG Medical Writing Technology Platform Prior authorization Quality improvement +23

USD 131K+

Data Scientist I, Decision Science
Remote

KPI Frameworks Utilization Trends Models Healthcare Analytics Technology Platform Financial Performance Pandas Claims Advanced Analytics +25

Entry Mid Full Time

USD 119K+

Senior Research Scientist, Humana Healthcare Research
Remote US

Interrupted time series analysis Difference in difference Propensity score analysis Large data analysis Statistical coding Inverse probability treatment weighting Administrative claims data Multivariate regression Regression discontinuity designs +47

Senior Full Time

USD 93K+

Claims Consultant - Management Specialty Lines (Surety, Construction Litigation)
Ohio-Work from Home-2

Construction litigation Training and Mentoring Insurance coverage Insurance Regulations Legal analysis Complex claims Litigation management Insurance Industry Claims handling +25

USD 93K+

Medicaid Lead, Technology Solutions
Work at Home - Oklahoma

Compliance Audits IT Strategy Documentation Management Healthcare operations Process Flows IT solutions Technology Trends RFP Enrollment +50

Senior Full Time

USD 115K+

Nurse Auditor 2
Remote US

Clinical audit Medical record documentation Coding certification Medical Record Review Medical claims CPT codes Clinical Review CPT Consumer Experiences +37

USD 69K+

Senior Compliance Professional
Remote US

Health Plan Operations Pharmacy operations Regulatory Analysis Analyzing Risk Claims processing Claims Strategic initiatives CMS +42

Senior Full Time

USD 84K+

Clinical DRG Auditor, Specialist (Remote Nurse in US)
Any city, ID, US, 99999

Gainwell Technologies

DRG Methodologies HMS Auditing Systems Clinical review judgment Clinical auditing Regulatory support MCC AP-DRG CC Internet browsers +57

Senior Mid Full Time

USD 59K+

Analyst, Gov/Reg Affairs
Remote

Rosco Legislative tracking Westlaw Appeals Appian Technology Platform Google Workspace Regulatory Affairs Claims +8

USD 71K+

Manager, Encounter Data Management
Remote US

X-12 data Business process development Large data sets Microsoft SQL CAS Analyzing Microsoft SQL Server Microsoft Office Applications Compliance Standards +51

USD 76K+

Clinical Claims Analyst - Remote in US
Any city, TX, US, 99999

Gainwell Technologies

Healthcare data systems Payment integrity analytics Analytic Solutions Predictive Analytics Edge Accuracy Data Strategy Processes Data Mining +37

USD 60K+

Senior Clinical Research Scientist
Remote US

Recommender system Spark/Scala Analytics Solutions Spark r Healthcare economics Clinical Informatics Business Insights Analyzing Network Analysis +65

Senior Mid Full Time

USD 93K+

Senior COBOL Programmer Analyst
Roseville, CA, US, 95747-6645

Gainwell Technologies

MainView FileAid Xpediter Abend-Aid ChangeMan MVS TSO IBM Mainframe Easytrieve +39

Senior Full Time

USD 100K+

Technical Director, Claims - Commercial Excess Surplus, and Specialty (CLESS Claims Coverage Litigation)
Arizona-Work from Home-2

Coverage litigation law Analytical proficiency Commercial general liability Insurance coverage Professional liability Strong Communication Complex claims Strategic Guidance Investigative +34

Exec Senior Full Time

USD 107K+

Provider Services Representative- Remote USA
Any city, OH, US, 99999

Gainwell Technologies

Hospital claims support Healthcare call center Clinical customer support Utilization Review Service Level Agreements Processes PC Claims Medical +22

Entry Mid Full Time

USD 25K+

Absence, Disability and Life Insurance Senior Associate
Atlanta, GA, United States

Group disability plans Vendor procurement FMLA Disability Management Revenue Generation Claims Auditing Underwriting Financial analysis +13

Senior Mid Full Time

USD 90K+

Remote P&C Licensed Insurance CSR
FL-Tampa NEW

PC navigation Emergency road service Cross-selling Claims Call Center Insurance Products Billing Data Entry Underwriting +5

Entry Mid Full Time

USD 43K+

Monroe County Michigan Home Based Field Auto Physical Damage Appraiser
MI-HMMI Empl Work From Home

Damage evaluation Estimating damages Coverage Analysis Litigation management Insurance Knowledge Subrogation Claims handling Negotiating Claims +13

USD 63K+

Clinical Education Specialist - Remote in US
Any city, FL, US, 99999

Gainwell Technologies

Clinical claims review Webinar delivery InterQual criteria DRG validation Medical record auditing Healthcare Policies Coding certification CCS Healthcare policy +39

Senior Full Time

USD 75K+

Medicaid Lead, Technology Solutions
Work at Home - Ohio

Compliance Audits Business Architecture IT Strategy Healthcare operations Process Flows RFP Strategic direction Enrollment Consumer Experiences +49

Senior Full Time

USD 115K+

Senior IT Project Manager - Healthcare Solutions
Any city, TX, US, 99999

Gainwell Technologies

Trizetto Qnxt Application implementation Posting Claims systems Healthcare Solutions IT Project Management Edge Healthcare systems +22

Senior Full Time

USD 86K+

Clinical Ideation Product Specialist - Remote in US
Any city, TX, US, 99999

Gainwell Technologies

Claims data analysis Audit and review criteria Claims recovery Program performance Healthcare payment methodologies Claims auditing Regulatory monitoring Policy Documentation Payment methodologies +46

USD 90K+

Claims Consultant, Casualty - E&S/Specialty (Construction Defect)
Ohio-Work from Home-1

Construction defect Property damage claims Bodily injury Complex claims Property Damage Investigative Reinsurance Insurance Claims Claims handling +21

Senior Full Time

USD 93K+

RCIS Claims Employee Development Specialist
Virtual, IL, US

Zurich Insurance

Educational design MS Suite Profitability Organizational Effectiveness Crop claims Crop insurance Risk Engineering Casualty insurance Insurance Industry +18

USD 83K+

AVP, Underwriting Officer Or VP Senior Underwriting Officer
Virtual, NJ, US

Zurich Insurance

Surety underwriting Market Facing Insurance Laws Sales Execution Casualty insurance Insurance Industry Creative Problem Solving Claims Safety +11

Senior Mid Full Time

USD 115K+

Sr. Trial Attorney- Law & Motion
California - Glendale, 100 West Broadway

Law & motion practice Trial Advocacy Strategic Legal Advice Personal Lines Civil Litigation Insurance defense Technology Utilization Casualty insurance Subrogation +25

Senior Full Time

USD 121K+

Clinical Quality Nurse Reviewer, Sr. Specialist - (RN Remote in US)
Any city, NC, US, 99999

Gainwell Technologies

Clinical quality review InterQual criteria Chart Audits Clinical criteria guidelines Productivity standards Medical Record Review RN license InterQual Clinical Criteria +28

Senior Full Time

USD 64K+

Sr Consultant, Product - E&S/Specialty (Casualty)
Arizona - Scottsdale, 18700 North Hayden Road

Claims litigation Form drafting Compliance review Business rules Actuarial Performance Measurement Casualty insurance Actuarial science Claims +42

Senior Full Time

USD 107K+

Associate Claims Specialist, Property (Remote Event Management)
Ohio-Work from Home-1

Claims systems Detail Orientation Reinsurance Insurance Industry Claims handling Claims Property Claims Claims management Pricing +14

Entry Mid Full Time

USD 42K+

Claims Specialist III, Casualty - E&S/Specialty (Construction Defect)
New Hampshire-Work from Home-2

Commercial general liability Training and Mentoring Bodily injury Litigation management Investigative General Liability Reinsurance Insurance Claims Claims handling +20

Senior Mid Full Time

USD 75K+

Claims Specialist I, Property - Weather (Remote Event Management Team)
Ohio - Columbus, One Nationwide Plaza

Claims systems Property Damage Personal Lines Insurance Knowledge Reinsurance Subrogation Fraud detection Claims handling Claims +20

Entry Mid Full Time

USD 42K+

Manager, Provider Installation – Central Region
Remote US

Dashboard metrics Reporting & Analysis Business Metrics Operational Management Network management Problem Management Risk Microsoft Access Listening +46

USD 76K+

Field Claims Specialist II, National Catastrophe Property - Personal Lines (North Eastern US)
Maryland-Work from Home-1

Estimate writing Catastrophe response Claims systems Property damage claims Property Damage Personal Lines Investigative Reinsurance Insurance Claims +26

USD 42K+

Prior Authorization Operations Manager
Any city, OH, US, 99999

Gainwell Technologies

NCPDP standards Specialty medications Medication pricing Electronic prior authorizations Pharmacy Claims NCPDP Clinical pharmacy Prior authorizations Clinical Criteria +24

Senior Mid Full Time

USD 113K+

Lead Research Scientist
Remote US

Spark/Scala Spark r Recommender Systems Clinical Informatics Claims analysis Business Insights Healthcare Delivery Health outcomes Network Analysis +67

Senior Mid Full Time

USD 123K+

VP, State Management Leader – Personal Lines
Ohio - Columbus, One Nationwide Plaza

Risk selection Commercial Lines Personal Lines Pricing strategies Insurance Industry Claims Regulatory requirements Pricing Influencing +25

Senior Full Time

USD 172K+

Clinical Investigation Lead
Remote US

Health systems operations Healthcare claims data Healthcare Claims Medical claims Business Insights Clinical Strategy Health outcomes Healthcare operations Medical Coding +48

Senior Full Time

USD 112K+

P&C Reserving Proposition Leader
Philadelphia, PA, United States

M&A Knowledge Reserving Technology Transformational Consulting P&C Insurance Sales initiatives FMLA Reserving Strategic communication Regulatory knowledge +20

Senior Full Time

USD 275K+

Medical Director - National Medicare Team
Remote US

Commercial health insurance Project team participation Managed Care Knowledge Clinical Standards Clinical group practice management Humana policies Medical interpretation Medical background National Guidelines +42

Exec Senior Full Time

USD 199K+

Business Intelligence Analyst
Remote US

Microsoft Power Apps Microsoft Power Automate Provider engagement Azure Synapse Analytics Azure Synapse Synapse Microsoft Power BI Power Apps Power Automate +70

Entry Mid Full Time

USD 65K+

Senior Programmer Analyst (UNIX/LINUX/C/ORACLE)
Any city, IN, US, 99999

Gainwell Technologies

QA activities Claims systems Unix/Linux Batch processing Healthcare administration Edge Logging Technical Consulting Test plans +33

Senior Full Time

USD 70K+

Territory Manager - Personal Lines (Western Iowa, North Dakota, South Dakota)
Iowa-Work from Home-1

Personal Lines Portfolio Management Claims Operational Efficiency Sales Management Life Insurance Financial Services Adaptability Continuous Improvement +18

USD 86K+

Grievance and Appeals Manager
Remote US

Grievance Management Appeals Management Medical claims Grievance and appeals Bilingual English and Spanish Cross-departmental collaboration Bilingual (English Microsoft Access Clinical Documentation +49

USD 84K+

Carrier Account Manager
Any city, TX, US, 99999

Gainwell Technologies

Micro Strategies CMS guidelines Microsoft Access Functions Processes Claims CMS Health Insurance Billing +30

USD 55K+

Casualty Case Management - Hybrid Albany, New York - Mostly Remote
Albany, NY, US, 12205

Gainwell Technologies

Third Party Liability Eligibility Microsoft Access Processes Functions Legal research Claims Claims management Proofreading +30

USD 37K+

General Claims Adjuster - Personal Lines (Large Loss)
Iowa-Work from Home-1

Field Investigations Personal Lines Insurance Claims Claims handling Xactimate Claims Property Claims Technical Assistance Consultation +16

Senior Full Time

USD 76K+

Counsel - Annuity and Life Insurance Operations
Ohio - Columbus, One Nationwide Plaza

Customer Correspondence Legal Opinions Tax Requirements Legal expertise Life Insurance Products Annuity products Legal support Legal Experience Annuity +25

USD 95K+

Casualty Case Management - Hybrid- Tallahassee, Florida
Tallahassee, FL, US, 32301-5020

Gainwell Technologies

Third Party Liability Microsoft Access Eligibility Functions Processes Legal research Claims Proofreading Claims management +30

Entry Mid Full Time

USD 24K+

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