Medical Claims Review Manager jobs in Provo, UT

Medical Claims Review Manager oversees the performance, productivity, and quality of the medical claims review staff. Responsible for hiring, training, and firing medical claims review staff. Being a Medical Claims Review Manager evaluates medical claims review processes and recommends process improvements. Serves as a technical resource for all medical review workers. Additionally, Medical Claims Review Manager typically requires an RN or BSN. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Claims Review Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Claims Review Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Product Manager
  • Claims Solutions
  • Lehi, UT FULL_TIME
  • Company Description


    We help the world see new possibilities and inspire change for better tomorrows. Our analytic solutions bridge content, data, and analytics to help business, people, and society become stronger, more resilient, and sustainable.


    Job Description


    Job Summary:
    Product Managers are responsible for overseeing and managing the production of software solutions throughout the entire Product Development Life Cycle (PDLC).

    • Develop, communicate, and execute the vision and strategy for property estimating software solutions.
    • Develop, prioritize, and maintain clear roadmaps, working closely with product executives to align priorities to value stream vision and strategy, along with a strong focus on innovation, customer needs, and value creation.
    • Maintain and communicate a prioritized list of features, capabilities, and product requirements to further the product direction.
    • Ensure product readiness by working with all stakeholders to provide necessary resources to successfully support the product and any product changes in their respective roles, this includes but is not limited to providing go to market strategy.
    • Establish, communicate, and manage release cadence of product.
    • Represent product during customer calls, internal/external meetings, and all other events that warrant product representation.
    • Research industry, market, customer feedback, and other sources to make data driven decisions to improve customer adoption and retention.
    • Track and report progress of product, including the success or failure of all stages.
    • Complete all responsibilities as outlined in performance objectives.
    • Complete all special projects and other duties as assigned.
    • Must be able to perform duties with or without reasonable accommodation.

    Qualifications
    • Bachelor’s degree in related field or comparable education and experience.
    • Proven track record of success in working with various stakeholders to build great software solutions.
    • A good understanding of how Artificial Intelligence can be used to solve problems.
    • A full understanding of property claims, restoration, and contracting industries preferred.
    • Proficient in Xactware products and workflows preferred.
    • Strong communication, presentation, and public speaking skills.
    • Ability to create and clearly communicate product roadmaps.
    • Ability to work on multiple projects in various stages simultaneously.
    • Demonstrated time/priority management.
    • Experience in Agile work management, including use of issue tracking software such as Jira.
    • Occasional travel required.

    #LI-AO1


    Additional Information


    For over 50 years, Verisk has been the leading data analytics and technology partner to the global insurance industry by delivering value to our clients through expertise and scale. We empower communities and businesses to make better decisions on risk, faster.

    At Verisk, you'll have the chance to use your voice and build a rewarding career that's as unique as you are, with work flexibility and the support, coaching, and training you need to succeed.

    For the eighth consecutive year, Verisk is proudly recognized as a Great Place to Work® for outstanding workplace culture in the US, fourth consecutive year in the UK, Spain, and India, and second consecutive year in Poland. We value learning, caring and results and make inclusivity and diversity a top priority. In addition to our Great Place to Work® Certification, we’ve been recognized by The Wall Street Journal as one of the Best-Managed Companies and by Forbes as a World’s Best Employer and Best Employer for Women, testaments to the value we place on workplace culture.

    We’re 7,000 people strong. We relentlessly and ethically pursue innovation. And we are looking for people like you to help us translate big data into big ideas. Join us and create an exceptional experience for yourself and a better tomorrow for future generations.


    Verisk Businesses

    Underwriting Solutions — provides underwriting and rating solutions for auto and property, general liability, and excess and surplus to assess and price risk with speed and precision

    Claims Solutions — supports end-to-end claims handling with analytic and automation tools that streamline workflow, improve claims management, and support better customer experiences

    Property Estimating Solutions — offers property estimation software and tools for professionals in estimating all phases of building and repair to make day-to-day workflows the most efficient

    Extreme Event Solutions — provides risk modeling solutions to help individuals, businesses, and society become more resilient to extreme events.

    Specialty Business Solutions — provides an integrated suite of software for full end-to-end management of insurance and reinsurance business, helping companies manage their businesses through efficiency, flexibility, and data governance

    Marketing Solutions — delivers data and insights to improve the reach, timing, relevance, and compliance of every consumer engagement

    Life Insurance Solutions – offers end-to-end, data insight-driven core capabilities for carriers, distribution, and direct customers across the entire policy lifecycle of life and annuities for both individual and group.

    Verisk Maplecroft — provides intelligence on sustainability, resilience, and ESG, helping people, business, and societies become stronger

    Verisk Analytics is an equal opportunity employer.

    All members of the Verisk Analytics family of companies are equal opportunity employers. We consider all qualified applicants for employment without regard to race, religion, color, national origin, citizenship, sex, gender identity and/or expression, sexual orientation, veteran's status, age or disability. Verisk’s minimum hiring age is 18 except in countries with a higher age limit subject to applicable law.

    https://www.verisk.com/company/careers/


    Unsolicited resumes sent to Verisk, including unsolicited resumes sent to a Verisk business mailing address, fax machine or email address, or directly to Verisk employees, will be considered Verisk property. Verisk will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume.

    HR CCPA Privacy Notice.pdf

  • Just Posted

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Medical Claims Specialist
  • Serenity Healthcare
  • Lehi, UT FULL_TIME
  • Medical Claims Specialist - Full-time *Onsite - Lehi, UT Serenity Healthcare is seeking a Medical Claims Specialist to provide the billing team with additional support in order to obtain financial com...
  • 8 Days Ago

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Structural Research Specialist
  • Claims Solutions
  • Lehi, UT FULL_TIME
  • Company Description We help the world see new possibilities and inspire change for better tomorrows. Our analytic solutions bridge content, data, and analytics to help business, people, and society be...
  • 20 Days Ago

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Billing specialist
  • Claims Solutions
  • Lehi, UT FULL_TIME
  • Job Description Job Summary : Part-time, 4 hours per day. Handle incoming calls regarding invoices, payments and account status. Assist customers with updating and maintaining contacts on the account....
  • 2 Days Ago

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Developer II
  • Claims Solutions
  • Lehi, UT FULL_TIME
  • Company Description We help the world see new possibilities and inspire change for better tomorrows. Our analytic solutions bridge content, data, and analytics to help business, people, and society be...
  • 1 Month Ago

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Executive Administrative Assistant
  • Claims Solutions
  • Lehi, UT OTHER
  • Company Description We help the world see new possibilities and inspire change for better tomorrows. Our analytic solutions bridge content, data, and analytics to help business, people, and society be...
  • 1 Month Ago

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0 Medical Claims Review Manager jobs found in Provo, UT area

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Remote Licensed Professional Counselor
  • Headway
  • Provo, UT
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/25/2024 12:00:00 AM

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Remote Licensed Marriage and Family Therapist
  • Headway
  • Provo, UT
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/25/2024 12:00:00 AM

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Remote Licensed Psychiatrist
  • Headway
  • Provo, UT
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/25/2024 12:00:00 AM

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Remote Licensed Mental Health Therapist
  • Headway
  • Provo, UT
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/25/2024 12:00:00 AM

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Remote Licensed Psychiatric Nurse Practitioner
  • Headway
  • Provo, UT
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/25/2024 12:00:00 AM

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Remote Licensed Clinical Psychologist
  • Headway
  • Provo, UT
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/25/2024 12:00:00 AM

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Remote Licensed Mental Health Counselor
  • Headway
  • Provo, UT
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/25/2024 12:00:00 AM

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Remote Licensed Clinical Social Worker
  • Headway
  • Provo, UT
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/25/2024 12:00:00 AM

Provo /ˈproʊvoʊ/ is the third-largest city in Utah, United States. It is 43 miles (69 km) south of Salt Lake City along the Wasatch Front. Provo is the largest city and county seat of Utah County. Provo lies in the Utah Valley at an elevation of 4,549 feet (1,387 m). According to the United States Census Bureau, the city has a total area of 44.2 square miles (114.4 km2), of which 41.7 square miles (107.9 km2) is land and 2.5 square miles (6.5 km2), or 5.66%, is water. The Wasatch Range contains many peaks within Utah County along the east side of the Wasatch Front. One of these peaks, known as...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$90,839 to $115,822
Provo, Utah area prices
were up 2.3% from a year ago

Medical Claims Review Manager in Paramus, NJ
Support management with leading Medical Review team to ensure all types of claims requiring medical reviews are completed in compliance with State, Federal, accreditation standards and other applicable regulations.
February 01, 2020
Medical Claims Review Manager in Nashua, NH
By truly combining claims and bill review, the two systems are kept in sync utilizing the scheduled jobs of the aforementioned standard model; however, for real-time data updates, claims examiners are granted access to the entire live bill review system.
January 13, 2020
Medical Claims Review Manager in Davenport, IA
Complex claim errors can only be caught by physician reviewers with the clinical experience to spot mistakes that automated systems can’t detect.
January 03, 2020