64 claims service manager jobs found in Charlotte, NC

As part of our Client Service team, you will serve as coordinator of implementation and claims service delivery for assigned clients. Use your knowledge and experience in claims management to effectively and efficiently partner with PMA departments to provide superior client service to self- insured and insured business while assisting PMA in meetings its business objectives. Services will be delivered through a combination of in person and virtual interactions with the client and broker.  This position can be based out of any of our offices in the Southeast Region. Responsibilities Participate in new business presentations and broker capabilities presentations. Coordinate orientation /implementation of new clients and serve as a point of contact for all service issues. Assist sales and underwriting efforts by representing PMA Companies to the marketplace through broker interactions, networking events, industry and specialty functions/conferences, etc. Coordinate vendor...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary The Account Manager is responsible for the day-to-day account management for small to mid-sized clients that are routine/moderately complex client accounts. Essential Duties and Responsibilities: Manages an assigned book of business and builds, expands, and solidifies relationships with existing clients Leads appropriate resources to address the client's risk/capital management needs Secures existing business and drives the sale of additional services and coverage levels Cultivates relationships with the most senior buyer in the client organization as well as...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary The Account Manager is responsible for the day-to-day account management for small to mid-sized clients that are routine/moderately complex client accounts. Essential Duties and Responsibilities: Manages an assigned book of business and builds, expands, and solidifies relationships with existing clients Leads appropriate resources to address the client's risk/capital management needs Secures existing business and drives the sale of additional services and coverage levels Cultivates relationships with the most senior buyer in the client organization as well as...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. We are seeking a Client Service Manager to join our growing team. Can you deliver exceptional customer service? Are you interested in helping a range of clients through issues that vary from relatively simple to moderately complex? We are looking for people who are passionate about building relationships with clients, will collaborate with the sales team to achieve goals, constantly seek improvement and will demonstrate the value Gallagher can provide. How will you affect the business? Take a leadership role in the renewal process to ensure the best possible solutions are delivered to...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. We are seeking a Client Service Manager to join our growing team. Can you deliver exceptional customer service? Are you interested in helping a range of clients through issues that vary from relatively simple to moderately complex? We are looking for people who are passionate about building relationships with clients, will collaborate with the sales team to achieve goals, constantly seek improvement and will demonstrate the value Gallagher can provide. How will you affect the business? Take a leadership role in the renewal process to ensure the best possible solutions are delivered to...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary The Account Manager is responsible for the day-to-day account management for small to mid-sized clients that are routine/moderately complex client accounts. Essential Duties and Responsibilities: Manages an assigned book of business and builds, expands, and solidifies relationships with existing clients Leads appropriate resources to address the client's risk/capital management needs Secures existing business and drives the sale of additional services and coverage levels Cultivates relationships with the most senior buyer in the client organization as well as...

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) The Sr. Hospital Account Manager is accountable for the full range of provider relations and service interactions within UHG, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. The Sr. Provider Relations Advocate designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. The successful candidate will direct and implement...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) As an Compliance Data Consultant, you’ll review data, look for patterns of potential fraud, waste and/or abuse and interact with the Special Investigations Unit (“SIU”) to complete investigations. You’ll be fully invested in the outcomes and will be helping the health system work better for everyone with the support and resources of a Fortune 5 industry leader.  You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Establish, mandate and implement standard policies, procedures and best practices regarding UnitedHealthcare Investigations’ claim...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) Optum Labs is the research and development arm of UnitedHealth Group. We're a diverse team of curious thinkers and experts in big data, artificial intelligence and machine learning, and scientific and clinical research searching for new ways to help people live healthier lives. We partner with world leaders in health care delivery, research, and technology to create disruptive solutions that serve patients, caregivers, providers, and commercial and government payers. More equitable, effective, and affordable health care -...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) Position in this function assesses and interprets customer needs and requirements. Identifies solutions to non-standard benefit and pricing requests and problems. Solves moderate to complex problems and/or conducts moderate to complex analyses. Works with minimal guidance; seeks guidance on only the most complex tasks. Translates concepts into practice. Provides explanations and information to others on difficult issues. Acts as a resource for others with less experience.   Primary Responsibilities: Maintain and perform intra-department audits Provide intra-departmental information and support on basic to difficult in-house...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) Community & State (C&S) Network Program Managers work closely with United Health Networks (UHN), C&S Healthplans, Implementation & Business Alignment (IBA), Teams within Provider Operations, and have a dotted line relationship to various IT teams as needed. C&S Network Program Managers are each assigned 3-5 active new state or product implementations at one time. Positions in this function are responsible for end-to-end project management and point person for all of  Provider Operations, coordination of cross-functional teams, & highlighting areas of risk and mitigation plans. You’ll enjoy the flexibility to...

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm) The Pharmacy Audit Rep Sr. will work on a wide range of activities to support pharmacy operations and initiatives to help meet goals and deliverables. Conducts audits of pharmacy claims in alignment with prior authorization requests and conducts audits of various pharmacy initiatives. Responsible for gathering and evaluating data from multiple sources to support ongoing pharmacy daily operations. Assist pharmacy leadership with business process and policy development of programs and productivity metrics. Assist with report development and analysis to support key initiatives and operations.  You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.  Primary Responsibilities: Supports daily operations...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) In joining the Optum Advisory Services Trend Analytics Consulting team: you’ll be part of a team that is leader in health care cost analytics, with a proven track record of supporting health plans across the country though a diverse staff of Actuaries, Data/Research Analysts, and Business/Technology Consultants.  Our consulting team has continued to expand capabilities and consulting presence by identifying, developing, and executing on new and exciting business opportunities.  As a member of our high-performing team,...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) As a Senior Healthcare Economics Data Analyst in Optum’s Product Analytics organization, you will perform critical data analytics that examine the effect of Optum Health’s Care Management products on costs and utilization of the members served.  Your role will include helping source data, helping develop and maintain data marts, partnering with internal stakeholders to understand and document data requirements, and...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) As a Senior Healthcare Economics Data Analyst in Optum’s Product Analytics organization, you will perform critical data analytics that examine the effect of Social Determinants of Health on the administration and outcomes of Optum Health products.  Your role will include data analytics for product development and pilot evaluations, partnering with internal stakeholders to understand and document data requirements,...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Support actuarial reports and analytics to support Part C and Part D bid development Conduct and evaluate studies on risk adjustment, utilization, and health care costs Perform mathematical analyses and actuarial modeling to provide project managers with...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.   Primary Responsibilities: Interpret and analyze claims, capitation, membership data, and recommend best approaches in support of underwriting, actuarial and utilization analyses Lead projects to completion by contributing to database creation, statistical modeling and financial reports Create and update automated processes Performs complex data validation and conceptual analyses. Analyze reporting tools utilized by the internal customer groups Serves as subject matter expert to health plans...

If you are located within Washington D.C, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing  your life's best work . SM This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST. It may be necessary, given the business need, to work occasional overtime. *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Primary Responsibilities: Respond to and resolve, on the first call, customer service inquiries and issues from several sources (Provider, Member, Customer) Research complex issues using multiple UMR proprietary...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do  your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Design actuarial reports and analytics to support Part C and Part D bid development Conduct and evaluate studies on risk adjustment, utilization, and health care costs Perform mathematical analyses and actuarial modeling to provide clients with statistical...

If you are located within Austin, TX, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM Senior Service Account Managers  are responsible for first-level response and resolution of escalated issues with external and internal customers. This position is full-time (40 hours/week) Monday to Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 08:00am – 05:00pm. It may be necessary, given the business need, to work occasional weekends. Our office is located at 1821 RUTHERFORD LN STE 300, AUSTIN, 78754. *All Telecommuters will be required to adhere to UnitedHealth Group’s...