19 jobs found in Des Moines, IA

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

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....

Program Manager - Contract Lifecycle Management Implementation Anywhere Type: Contract Category: Program/Project Management Industry: Technology Workplace Type: Remote Reference ID: JN -032026-105956 Date Posted: 03/12/2026 Shortcut: http://careers.eliassen.com/ZA0OkN Description Recommended Jobs Description: Remote Our client is seeking a Program Manager to lead a Contract Lifecycle Management implementation within a broader Finance and Legal transformation. The role will own strategy, roadmap, and delivery across legal, finance, and technology stakeholders while managing risks, vendors, and change. The manager will drive process design, configuration guidance, and adoption to improve contract efficiency, visibility, compliance, and automation. This program leader will ensure alignment with the digital transformation ecosystem and deliver measurable outcomes. Due to client requirements, applicants must be willing...

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: Use most up to date job description. To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo...

Intern - Service Delivery ManagementRemote - United StatesJR012789 At Ensono, our Purpose is to be a relentless ally, disrupting the status quo and unleashing our clients to Do Great Things! We enable our clients to achieve key business outcomes that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to keep up with continuous change and embrace innovation. We can Do Great Things because we have great Associates. The Ensono Core Values unify our diverse talents and are woven into how we do business. These five traits are the key to achieving our purpose: Honesty, Reliability, Collaboration, Curiosity, Passion About the role and what you'll be doing: We are looking for potential participants for our 2026 Summer Internship Program and are excited to invite driven and self-motivated candidates to apply! Ensono is dedicated to cultivating talented individuals with...

Intern - Capacity Management Data AnalystRemote - United StatesJR012790 At Ensono, our Purpose is to be a relentless ally, disrupting the status quo and unleashing our clients to Do Great Things! We enable our clients to achieve key business outcomes that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to keep up with continuous change and embrace innovation. We can Do Great Things because we have great Associates. The Ensono Core Values unify our diverse talents and are woven into how we do business. These five traits are the key to achieving our purpose: Honesty, Reliability, Collaboration, Curiosity, Passion Role Summary As an intern at Ensono, you will have a direct impact working with your team and also take part in programming provided by our Training and Development team. This will include project work, professional development, a business challenge...

Job Description Oracle Cloud is the next generation cloud service built from grounds up for the most demanding application requirements with diverse performance, reliability, and governance requirements for a variety of customer use cases. We've focused on security, reliability, scalability, and flexibility to support existing and future enterprise level large and complex deployments while beating industry performance and pricing standards. We are rapidly expanding our footprint and continuously building innovative solutions. Do you want to be part of a highly technical team helping to establish Oracle Cloud as the leading cloud computing platform for enterprises? Are you passionate about making customers successful? Oracle Cloud is seeking a leader for the Distributed Cloud busines s. This role has a global responsibility over technical and business programs for Distributed Cloud. A successful leader will have experience in working with geographically separated teams...

Role Title: Lead Specialist, Product Management Description: This role aligns to a Principal Product Manager Location: Hoboken - Hybrid About Pearson: At Pearson, we are committed to helping people make progress in their lives through learning. We create innovative and accessible educational products and services that foster personal and professional growth. We are looking for a passionate and skilled Product Director (IC) to join our team and drive the development of cutting-edge educational products. About the Job: We embrace the SVPG Product Operating Model by empowering our product teams to solve hard problems – customer problems and business problems – in ways that our customers love yet work for our business. Our product teams are cross-functional, durable and generally comprised of a product manager, product design, tech lead and a program manager (4-in-a-box model). We staff our product teams with the skills necessary to come up with effective solutions...

Clinical Quality Management Program Manager (Part-time) Fully Remote-United States Job Type Part-time Description Overview Tanaq Management Services (TMS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture, technology, and other government services. TMS is a subsidiary of the St. George Tanaq Corporation, an Alaskan Native Corporation (ANC) committed to serving Federal customers while also giving back to the Tanaq native community and shareholders. About the Role We are seeking a part-time Clinical Quality Management Program Manager to serve as the primary point of contact for all contractual, technical, and administrative matters supporting the Clinical Quality Management (CQM) Program at the Defense Health Agency (DHA). The Clinical Quality Management Program Manager will provide day-to-day leadership, planning, coordination, and oversight of project staff and...

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: As a Physician Clinical Reviewer, Interventional Pain Management, you will be a key member of the utilization management team. We can offer you a meaningful way to make a...

Company : enGen Job Description : JOB SUMMARY This pivotal role will lead the strategic transformation and optimization of workforce operations across enGen, encompassing both internal resources and external vendors. The Senior Director will be a key driver in establishing robust frameworks for tracking hours, managing financial allocations, and ensuring highly efficient resource deployment. This individual will possess a deep understanding of transformational initiatives, serving as a change expert who can intelligently engage with vendors, internal stakeholders, and senior leadership to align business operations with strategic objectives and deliver significant value. This leadership role is responsible for influencing, shaping, and executing high-impact strategies and initiatives delivering significant enterprise-level value. The Senior Director level demands a high degree of strategic leadership, independent decision-making, and accountability for fostering...

Nelnet Business Services (NBS), a division of Nelnet, Inc., provides payment technology, education services, and learning management solutions to education and faith-based organizations, serving more than 1,300 higher education institutions, 11,500 K-12 schools, 3,500 churches, and millions of individual students, families, and supporters across the globe. Our culture of service enables us to form long-lasting and trusted partnerships, while our focus on creativity and innovative solutions empowers our customer communities to thrive. As a Nelnet company, the perks at NBS go beyond our benefits package. You're part of a community, invested in you as an individual and united by our mission to create opportunities for people where they live, learn and work. The IT Service Management (ITSM) Analyst serves as the primary Major Incident Manager during assigned on-call rotations, leading real-time response to high-severity incidents and contributing to operational stability and site...

Job Description Oracle's Global Sustainability Office is seeking a dynamic and strategic leader to serve as a Program Management Director of Sustainability Reporting & Engagement. This high-impact role will oversee the functions of external sustainability communications, regulatory and voluntary reporting/disclosures, and internal employee engagement programs. The successful candidate will provide visionary leadership, manage and develop a multidisciplinary team, and drive Oracle's sustainability disclosures and communications in alignment with corporate growth and global regulatory trends. This role is for Nashville, TN. Candidate must live or be willing to relocate to Nashville, TN for this role. Key Responsibilities: Lead, develop, and inspire a team responsible for the strategic direction and execution of Oracle's sustainability reporting, external disclosures and communications, employee engagement and business enablement. Oversee the preparation...

Job Description The Oracle Dedicated Cloud Product Management team is looking for an experienced Senior Manager of Product Management to work across our Dedicated Region Cloud @Customer (https://www.oracle.com/cloud/cloud-at-customer/dedicated-region/) (DRCC) and Oracle Alloy (https://www.oracle.com/cloud/alloy/) offerings to focus on product Definition, Development, and Launch. The Senior Manager of Product Management for Oracle Dedicated Cloud is a leadership role responsible for defining, executing, and driving the product development with our outbound and engineering internal teams. The role carries broad influence, significant business impact, and ownership of mission-critical product releases and launches aimed at driving OCI's growth and success in global markets. The primary objective will be to define, manage and deliver the product solutions that resonate with customers. This should include managing the full portfolio roadmap for DRCC and Alloy across its...

Director, Product Management: Capital One Shopping (Remote - Eligible) About Capital One Shopping Capital One Shopping is an industry-leading consumer technology business that is changing the way people buy and save online. The team operates with extreme focus to accelerate growth of the Shopping business, find best-in-market savings for shoppers, and create unique value for our merchant partners. Technology and a rapid test-and-learn methodology are applied to nearly all of our business challenges. The team has a flat organizational structure that emphasizes clear ownership, small teams, and leverage through technology. We are looking for a Product Director to join our team to improve and integrate new product and revenue opportunities with our merchant partners, and drive cross-functional execution within Shopping. This Product Director will have a demonstrated interest and aptitude for AI. While formal on-the-job experience with AI is a plus, we highly value candidates...

Location: Anywhere in Country At EY, we’re all in to shape your future with confidence. We’ll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world. Our objective is to provide clients with a unique business perspective on how to leverage SAP technology to enhance their operations. This is rooted in EY's SAP service line capabilities including Supply Chain, FICO, BPC, Data & Analytics, Customer, Tech/Arch and SuccessFactors. Our focus is on helping clients elevate performance and productivity. The opportunity EY's Agile Business Transformation enabled by SAP technology can help organizations address challenges in the digital era. Our EY SAP collaborative approach focuses on more than technology alone. We take a comprehensive, business-first view to address strategy, customer value, user experiences, processes, technology, and operational impacts in tandem. As...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Location: Anywhere in Country At EY, we’re all in to shape your future with confidence. We’ll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world. In an ever-evolving IT landscape, EY stands as a beacon of trust for clients across diverse industries seeking reliable solutions to address their intricate risks and vulnerabilities. As a vital member of our Identity and Access Management (IAM) team, you will play a central role in achieving this objective by empowering clients to comprehend and navigate their complex Enterprise Identity environments. Your expertise will be instrumental in evaluating, enhancing, and devising innovative solutions, processes, and policies to cater to each client's unique IAM requirements. This is an opportunity to leverage both your technical prowess and business acumen to drive our mission and make a significant impact on global...

Position Description & Qualifications If you love high profile and challenging projects supporting the US Army, then Serco has a great opportunity for you! As the Senior Logistics Management Specialist, you will be part of the Global Logistics Augmentation and Staff Support (GLASS) team supporting the Army Sustainment Command (ASC) in Vinceza, Italy. Bring your expertise and collaborative skills to make an impact towards our military defense. At Serco, we foster a dynamic and collaborative work environment where team members contribute to innovative, high-impact projects for leading government clients. We provide opportunities to solve complex challenges, improve processes, and utilize the latest technologies to deliver top-tier products and services to our customers. The positions on this contract are located both CONUS and OCONUS in support of the Army Sustainment Command (ASC). In this role, you will: Develop and maintain LOGCAP contract requirements...