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Claims representative Jobs in Albuquerque, NM

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Claims representative • albuquerque nm

Last updated: 4 days ago

Program Manager (Claims - MST hours)

Molina HealthcareAlbuquerque, NM, United States
Full-time

Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vend... Show more

Insurance Sales Representative

Aaron Sanchez Farmers InsuranceAlbuquerque, NM, US
Full-time
Quick Apply

Our agency is looking for a confident and highly motivated individual that's interested in a great sales opportunity.Great earnings with future long term career advancement available.As an Insuranc... Show more

Pathways Recent Graduate Claims and Program Representative

US Government JobsAlbuquerque, NM, United States
Full-time

This position is located in the Railroad Retirement Board's Field Service.The incumbent will be responsible for providing a full-range of client services regarding benefits available under the vari... Show more

Assistant Claims Risk Manager

Catholic Mutual GroupAlbuquerque, NM
Full-time

Catholic Mutual Group (CMG) is the leading provider of property, liability, and employee benefit coverage and related services for the Catholic Church across the United States and Canada.We are cur... Show more

Sales Representative

Colonial LifeAlbuquerque, NM, US
$50,000.00 yearly
Full-time
Quick Apply

Colonial Life’s New Mexico territory is looking for motivated independent agent sales representatives to connect with customers and offer voluntary benefits that provide employees with financial pr... Show more

Hospice Marketing Representative

Heritage Healthcare ServicesAlbuquerque, NM, US
Part-time
Quick Apply

Heritage Hospice is excited to resume services in the Albuquerque community.Our dedicated team is back and ready to provide compassionate, high‑quality end‑of‑life care for patients and families ac... Show more

Workers Compensation Claims Supervisor - NM

Arthur J Gallagher & CoAlbuquerque, NM, United States
Full-time

At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose.Every day, we help clients navigate complexity,... Show more

Inside Sales Representative

Nucor Rebar Fabrication SouthwestAlbuquerque, NM, US
Full-time

Nucor is seeking an Inside Sales Representative in Albuquerque, NM to serve as a key liaison between sales, production, shipping, and management while delivering exceptional customer support.The to... Show more

Regional Sales Representative

GpacAlbuquerque, New Mexico, United States
Full-time
Quick Apply

This is an exciting opportunity to represent a respected industrial manufacturer known for precision gearing, custom gearbox solutions, gearbox repair and rebuild work, and.What Makes This Opportun... Show more

Worker Compensation Claims Examiner III (Hybrid)

TRISTAR Insurance GroupAlbuquerque, NM, United States
$88,000.00 yearly
Full-time

Worker Compensation Claims Examiner III (Hybrid).Hybrid Albuquerque Office - Albuquerque, NM 87110.Under minimal supervision, manages all aspects of indemnity claims handling from inception to con... Show more

Commercial Claims Adjuster - Carrier or TPA - REMOTE

Work At Home Vintage ExpertsAlbuquerque, NM, US
Remote
Full-time +2
Quick Apply

Put your Insurance Experience to work – FROM HOME!.Our unique platform provides you with.WHAT YOU’LL LOVE ABOUT WAHVE.We created a welcoming place to work with friendly and professional... Show more

Sales Representative

WestGroupeAlbuquerque, NM, US
Full-time
Quick Apply

Company Description WestGroupe is a Canadian based eyewear company established in 1961.With over 60 years of experience, we provide unique and high-quality eyewear for the fashion-conscious consume... Show more

Pathways Recent Graduate Claims and Program Representative

US Government Jobs - Other AgenciesAlbuquerque, NM, United States
$52,059.00 yearly
Permanent

Pathways Recent Graduate Claims And Program Representative.The RRB Recent Graduates Program affords developmental experiences in the Federal Government intended to promote possible careers in the c... Show more

Workers Compensation Claims Supervisor - NM

GallagherAlbuquerque, New Mexico
Full-time

Role specifics: Claims Background: Workers Compensation Prior leadership experience: 1-2+ years of supervisory experience Jurisdictional experience: NM Licenses: NM Location: This role is eligible ... Show more

Sales Representative

Dreamstyle Remodeling | Renovo Home PartnersAlbuquerque, NM, United States
$100,000.00–$250,000.00 yearly
Full-time

At Dreamstyle Remodeling, we represent the finest brand names in home improvement.The combination of quality products, skilled professionals, and exceptional service makes Dreamstyle Remodeling the... Show more

Customer Service Representative

Glaz-Tech IndustriesAlbuquerque, New Mexico, United States
$17.00 hourly
Full-time

Position: Entry Level Order Specialist/ Customer Service Representative.Bluewater Rd NW, Albuquerque, NM  87121.Depending on Experience) with 90 Day Pay Rate Change Based on Eva... Show more

Sales Representative

LB Capital, LLCAlbuquerque, NM, US
$85,000.00 yearly
Full-time

K Minimum Earnings – A True Six-Figure Trajectory from Day One.The Best Commission Structure in the Industry.Monthly Bonuses Based on Revenue.The more you close, the more you earn.Bigger deals mean... Show more

Outside Sales Representative

US LBMAlbuquerque, NM, United States
Full-time

US LBM is one of the leading and fastest growing distributors of specialty building materials in the United States, with a team of over 15,000 employees located throughout the country.Since our fou... Show more

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Program Manager (Claims - MST hours)

Program Manager (Claims - MST hours)

Molina HealthcareAlbuquerque, NM, United States
30+ days ago
Job type
  • Full-time
Job description

Job Description

Job Summary

Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as applicable.

Job Duties

  • Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective claims & claims configuration program.
  • Manages program budget, as applicable, supporting project prioritization.
  • Collaborates with Legal, Compliance, and Information Security to ensure governance standards are upheld.
  • Tracks performance metrics and ensures value realization from deployed solutions.
  • Coordinates recurring meetings to support governance framework and decision-making processes, as needed.
  • At the direction of program (CoE, Shared Service or other functional area) leadership, supports portfolio management and/or initiative-specific change and project management.
  • Collaborates with key stakeholders to support dissemination and adoption of program guardrails, processes, best practices and other collateral.
  • Routinely reviews program collateral to ensure current and accurate reflection of business needs.
  • Identifies opportunities/gaps and provides recommendations on program enhancements to respective leadership team.
  • Responsible for creating business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
  • Generates and distributes standard reports on schedule.

Job Qualifications

Required Qualifications:

  • At least 4 years of Program and/or Project management experience, or equivalent combination of relevant education and experience.
  • Operational Process Improvement experience.
  • Managed Care experience, preferably in a shared service, CoE or matrixed environment.
  • Experience with Microsoft Project and Visio.
  • Strong presentation and communication skills.

Preferred Qualifications:

  • Claims & claims configuration experience.
  • QNXT
  • Provider Relations

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.