41 general claims manager jobs found

Job Summary Under the direction of the Director/Associate Director of Clinical Management, the Senior Clinical Study Manager is responsible for the oversight and management of Otsuka clinical studies, including coordination with other relevant parties (e.g., other Otsuka departments, external service providers (ESPs), etc.). Responsibilities include the planning, execution and completion of clinical trials according to applicable regulations and guidance; ICH Guidelines Good Clinical Practices (GCP), and Otsuka SOPs, within agreed-upon timeframes and budget. Job Description Provides oversight and management of clinical studies at Otsuka, including planning, execution, and completion of clinical trials according to all applicable regulations and guidance, ICH/GCP, and Otsuka SOPs. Contribute to the development and review of all critical clinical study documents, including clinical protocols, informed consent forms, or other study-related clinical documents....

The Global Quality Audit Manager is responsible for planning, executing, and reporting on global audits to ensure Good Clinical Practice (GCP) compliance across Contract Research Organizations (CROs), clinical laboratories, and clinical investigator sites. This role plays a critical part in maintaining the integrity of clinical trial data and ensuring patient safety by verifying adherence to regulatory requirements and internal standards. As a key member of the Global Quality Management team, the Audit Manager will collaborate with cross-functional stakeholders to identify risks, drive continuous improvement, and support inspection readiness across the clinical research landscape. Key Responsibilities Audit Execution : Plan, conduct, and report GCP audits of CROs, clinical laboratories, and investigator sites globally, ensuring compliance with ICH-GCP, local regulations, and company policies. Provide oversight to contract and consultant resources in audit...

Job Summary The Senior Manager of Global Quality Management (GQM) supports the execution of clinical quality activities to ensure compliance with Good Clinical Practice (GCP), regulatory requirements, and internal standards across global clinical trials. This role provides hands-on quality oversight, supports audit and inspection readiness, and collaborates with internal teams and external partners to maintain high-quality standards throughout the clinical development lifecycle. Key Responsibilities Clinical Study Support Serve as a GCP quality resource to clinical teams during study planning, conduct, and close-out. Support the review of study documents (e.g., protocols, monitoring plans, vendor agreements) for quality and compliance. Assist in identifying and resolving quality issues, protocol deviations, and potential noncompliance. Collaborate with Clinical Operations, Regulatory Affairs, and Medical Affairs to embed quality practices...

Job Description Are you a results-oriented sales specialist with a strong background in supply chain transformation? Do you have a track record of driving SaaS growth across complex sectors like healthcare, distribution, and life sciences? If so, this is your opportunity to lead strategic engagements across North America and shape the future of digital supply chains. At Oracle, we are redefining healthcare and life sciences operations through intelligent, cloud-based supply chain solutions. Oracle Supply Chain Management (SCM) Cloud connects procurement, planning, logistics, and inventory with financial and operational systems - driving efficiency, resilience, and performance. We are looking for a high-performing Supply Chain Solution Sales Specialist (SSE) to lead Oracle SCM solution sales across life sciences and pharmaceutical organizations in NA. Join us and play a key role in enabling our customers' digital future. Responsibilities Develop and execute regional...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Coordinator, Intake Utilization Management at Evolent will serve as a point of contact for processing prior authorization requests in accordance with departmental policies,...

Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area. Independently sets priorities and makes decisions on work approach while following established direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Humana's Encounter Data Management (EDM) team is seeking an Encounter Data Management Professional that has experience with business processing and data...

Anticipated End Date 2025-12-25 Position Title Utilization Management Representative I Job Description Utilization Management Representative I Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours: Working hours will be 10:30 AM to 7 PM Eastern. Training hours may vary. Training is 6 weeks and may require reporting to the nearest office. The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. How you will...

Job Summary The Manager, Clinical Operations works closely with the OPDC Monitoring Oversight Lead to manage monitoring oversight activities including managing Clinical Monitoring Consultants (CMC) contracted to perform monitoring oversight duties as well as escalating issues related to CRO monitoring quality. While focusing on quality and compliance, uses metrics and key performance indicators to drive monitoring oversight activities to achieve timelines and deliverables across the portfolio. Additionally, the Manager, Clinical Operations will support planning, resourcing, contracting, and budgeting of CMC resources to conduct monitoring oversight tasks. The Manager, Clinical Operations will also coordinate reporting and review of CRO related Key Performance Indicators (KPIs) Monitoring Oversight Lead. Job Description Manage Monitoring Oversight activities in North America, and other regions as assigned With the OPDC Monitoring Oversight Lead, plan...

The Manager, Manufacturing Product Quality (Small molecule) is responsible for ensuring GMP compliance in the manufacturing packaging, labeling, and distribution of commercial and clinical trial materials across global operations. This role supports the oversight of manufacturing and packaging activities performed internally and at external vendors, ensuring that quality standards are met and regulatory requirements are maintained throughout the commercial and clinical supply chains. The manager will collaborate with cross-functional teams including Clinical Operations, Regulatory Affairs, and Supply Chain to ensure the integrity and traceability of investigational products from manufacturing and packaging through delivery. Key Responsibilities Oversee manufacturing of commercial and clinical products at contract manufacturers to ensure compliance with GMP, and applicable global regulatory requirements. Performs batch record review and quality release...

Job Description Remote: This position does not require employee to be on-site full-time to perform most effectively. The employee's role enables them to work off-site on a permanent basis. This position requires an employee to cover territory visits to dealerships in a reoccurring frequency. This territory covers dealerships within the Northeast Region. The selected candidate must live within a 50-mile radius of Danbury, CT or relocate to assigned territory. This job may be eligible for relocation benefits. The Role The Customer Experience Team within Customer Care and Aftersales (CCA) is laser focused on delivering a leading customer experience. We attract more customers by focusing on processes which drive retention and contribute to the revenue that we generate in CCA. We elevate every customer engagement to improve outcomes for our dealers and customers. We remove obstacles and provide support to our field team to drive high-impact process improvements...

Job Summary The Field Force Effectiveness team at Otsuka America Pharmaceutical, Inc. plays a highly visible role in optimizing the performance of the sales and marketing efforts, for the field sales teams. As a result, Systems Training plays a key role in ensuring that the sales force understands how to effectively utilize our technology to enhance customer interactions, optimize selling opportunities and provide insight on our business processes that support our business. The Senior Manager of National Systems Training work with the field sales teams to design, develop and deliver new hire systems tech training on our InGenius (CRM System), ORION (Field Reporting) and Business Planning system across all brands. The role is also responsible or continual training on system enhancements and capabilities for the organization. In addition, the role will require system training content updates and cross collaboration between systems owners and multiple departments such as...

Senior Manager, Reinsurance Accounting Wilton, CT or Parsippany, NJ The Manager, Reinsurance Accounting, is a key member of AIG’s Reinsurance Controllership team ensuring accurate accounting, robust internal controls and timely financial reporting for AIG’s domestic Commercial and Personal insurance businesses. Reporting to the Director, External Reinsurance, this role is primarily responsible for managing the financial and operational controlling activities associated with multiple complex external reinsurance programs. Given the level of complexity across these programs, this role is structured with three direct reports and an extensive offshore platform. Success in this role will require a strong and well-balanced combination of re/insurance technical knowledge, operational savvy with an ability to efficiently leverage all levels of available resources, connecting operational inputs and outcomes to the financial results of AIG, organizational dexterity with...

Job Summary Senior Manager, Digital Content and Social Strategy Position Overview The Senior Manager, Digital Content & Social Strategy is responsible for shaping and amplifying Otsuka's external digital presence across our corporate website, social platforms, and emerging digital touchpoints. This role drives integrated content strategies that elevate our corporate voice, strengthen reputation, and build advocacy for our science, our leadership, and our commitment to redefining what's possible for the people we serve. Reporting to the Director of Corporate Brand and Reputation, the Senior Manager leads corporate website governance, social media strategy, analytics, digital storytelling, and executive social programs. This professional excels at cross-functional collaboration, "story mining," and translating complex concepts into compelling, audience-centric narratives. Key Responsibilities Corporate Website Content & Governance Own content...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Georgia Medicaid Clinical Account Manager - Remote Job Description Innovative business clinician accountable for building and maintaining customer relationships as well as leadership of the account teams within all assigned accounts. Charged with delivering results that demonstrate value to the customer, derived from identifying, demonstrating and selling valued pharmaceutical care and cost solutions that meet the desired outcomes of the customer; general management of the account, including P&L responsibility; and accountability for contract compliance.Accountable for developing and executing the strategic plan for their accounts in conjunction with sales and operations. Responsibilities Performs customer...

The Manager, Global Product Quality - Controlled Substances is responsible for ensuring that all activities related to controlled substances across the product lifecycle meet Good Manufacturing Practices (GMP) and comply with global regulatory requirements, including DEA regulations. This role partners closely with R&D, Supply Chain, Product Development, and Warehousing & Distribution teams to ensure robust quality oversight and regulatory compliance in the handling, storage, manufacturing, and distribution of controlled substances. Key Responsibilities Product Oversight: Provide GMP oversight and guidance during the drug development process including review and approval of documentation and collaboration and oversight of suppliers/contract manufacturers. Act as a liaison with regulatory agencies and internal compliance teams regarding controlled substance matters. Quality & Compliance:Serve as the quality and compliance lead for controlled...

The Manager, Data Analytics is an important role within the Medical Excellence & Operations team within Global Medical Affairs. This role will serve as the data and analytics lead supporting operational excellence across the Global Medical Affairs organization. This role is responsible for collecting, analyzing, and translating data into actionable insights that inform medical strategy, field engagement, performance measurement and medical strategy. The Manager, Data Analytics will work closely with both Field Medical and Headquarters teams to understand business needs and system requirements, support development of analytical solutions and other projects to drive key business processes and decisions for the Medical Affairs function. This role reports into the Business Solutions & Analytics Lead who reports into the Executive Director, Medical Excellence and Operations. Job Description Key Responsibilities: Data Collection, Management and Governance...

The Manager, Contracts (Non-HCP SOWs) is an important role within the Medical Excellence & Operations team within Global Medical Affairs. This role is responsible for end-to-end management of contracts that support Global Medical Affairs operations, excluding those with healthcare professionals or organizations. This includes agreements with vendors, consultants, technology platforms, contract research organizations (CROs), publication and medical education vendors, and other third-party service providers. This role will support the Global Medical Affairs team to ensure efficient operations, compliant contracting that align with global and regional regulations, Otsuka policies and GMA goals. This role reports directly into the Vendor Contracts and Management Lead who reports into the Executive Director, Medical Excellence and Operations. Job Description Key Responsibilities Include: Contract Development and Management Expertise Lead drafting, reviewing,...

The Manager, Global Product Quality - Clinical Packaging is responsible for ensuring GMP and GCP compliance in the packaging, labeling, and distribution of clinical trial materials across global operations. This role supports the oversight of clinical packaging activities performed internally and at external vendors, ensuring that quality standards are met and regulatory requirements are maintained throughout the clinical supply chain. The manager will collaborate with cross-functional teams including Clinical Operations, Regulatory Affairs, and Supply Chain to ensure the integrity and traceability of investigational products from packaging through delivery. Key Responsibilities Oversee clinical packaging operations to ensure compliance with GMP, GCP, and applicable global regulatory requirements. In collaboration with the supplier quality team, support qualification and monitoring of external clinical packaging vendors, including audits and performance...

The Senior Manager, Centers of Excellence (CoEs) is responsible for establishing, leading, and optimizing one or more prioritized CoEs within the Global Quality Operations organization-such as Inspection Readiness, Audit Effectiveness, or other strategic focus areas. This role drives execution of CoE initiatives, develops tools and frameworks, and delivers performance metrics and dashboards to support continuous improvement and operational excellence. The ideal candidate will have strong global collaboration skills and experience working across cross-functional teams in a matrixed environment. Key Responsibilities Centers of Excellence Leadership Lead the development and execution of one or more CoEs (e.g., Inspection Readiness, Audit Effectiveness) aligned with global quality priorities. Establish CoE charters, operating models, and governance structures to ensure clarity and accountability. Develop and maintain tools, templates, and guidance documents...

Job Summary The Manager, LMS Operations & Administration position works as part of the U.S. Ethics & Compliance Training & Documentation team to lead all components of our Learning Management System (LMS) including all non-GxP assignments and audience management, curriculum management, reporting, and tier one trouble shooting. The Manager, LMS Operations & Administration will partner with all levels of Management in both business and technology groups to advance and deliver a variety of planned and ad-hoc training initiatives. This position will have direct oversight of two Contracted Workers. Job Description Responsible for the operational oversight of all LMS activities including but not limited to: Partner with internal LMS Support Team to perform needs assessments and analysis on platform operations to ensure organizational needs are being met. Leads the incorporation, socialization, and training of resulting LMS improvements. Owns...

Job Summary The Manager, HCP Engagement Lead is a dedicated execution role responsible for the day-to-day operation and administration of the R&D Healthcare Professional (HCP) engagement and contracting process. This position is the primary point of contact for internal stakeholders seeking to engage external experts and is accountable for ensuring all contracts, payments, and documentation are processed efficiently, compliantly, and in accordance with the CoE's established "white glove" service standards. This role supports the Associate Director in maintaining the integrity of the centralized system and achieving audit-readiness. This position reports directly to the Associate Director, R&D HCP Engagement Center of Excellence (CoE). Job Description Key Responsibilities Include: Operational Execution and Contract Management Execute the end-to-end HCP contracting workflow, including drafting agreements, securing internal approvals, and managing...

Fiscal/Administrative Manager 1 Recruitment # 251211-0914AR-001 Location Newington, CT Date Opened 12/13/2025 12:00:00 AM Salary $106,755 - $145,565/year Job Type Open to Agency Employees Close Date 12/22/2025 11:59:00 PM Go Back Apply View Benefits (https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + Introduction Are you self-motivated? Do you enjoy supervising staff engaged in fiscal, administrative and operations functions? Are you a current Department of Transportation (DOT) employee looking to advance your career within the agency? If so, we encourage you read below & apply today! The State of Connecticut (https://portal.ct.gov/) Department of Transportation (DOT) (https://portal.ct.gov/dot) , Bureau of Finance and Administration, is currently recruiting for a Fiscal/Administrative Manager 1 (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=0126MP&R1=undefined&R3=undefined) position, for the Division of...

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards....

Job Summary Within Otsuka Pharmaceutical Co. exists Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC) a U.S.A. subsidiary exists the Global Clinical Development (GCD) department. OPDC-GCD are a group of physicians and scientists who lead clinical development activities for Otsuka's global health-care products. The Global Clinical Development Program Leader is responsible for leading the end-to-end strategy, and development and delivery of a portfolio of novel serotonergic agonists (NSA). Shaping and executing late-stage clinical development strategies for the NSA portfolio of therapeutic assets, ensuring programs progress efficiently toward registration and commercialization. This role serves as the primary and single point of contact for internal and external stakeholders, ensuring seamless integration, governance, and lifecycle management from early-stage development through submission to global health authorities. This role provides scientific,...