Oversee a diverse portfolio of risk management programs with a primary emphasis on Workers' Compensation and additional casualty-related lines of coverage, serving as the strategic liaison between clients and CCMSI service teams.
Compensation
Salary Range: $95,000 - $105,000
Responsibilities
Build and maintain strong relationships with assigned client accounts through regular communication and strategic partnership.
Understand client goals and objectives and coordinate service strategies that support desired outcomes.
Partner with claims, accounting, underwriting, loss control, and other internal teams to ensure quality service delivery.
Review and communicate operational and program performance data, reports, and recommendations to clients.
Monitor client programs and identify opportunities for process improvement, efficiency, and enhanced service.
Requirements
Bachelor's degree or equivalent experience
Nice to have: Multi-line casualty program experience
Nice to have: Self-insured account support
Nice to have: Healthcare and manufacturing industry client experience
Nice to have: Prior account management experience within a TPA, carrier, broker, or risk management organization
The Executive Director, Claims & Payment Integrity Strategy will report to the VP, Claims & Payment Integrity of Aetna and serve as the central strategic integrator across the end‑to‑end claim lifecycle, accountable for aligning Claims & PI strategic plan, operational oversight, capital submissions and overall structure of the team.
Compensation
The typical pay range for this role is: $131,500.00 - $303,195.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.
Responsibilities
Partner with Claims & Payment Integrity (CPI) leadership to develop and execute the enterprise strategy across 12‑month, 3‑year, and 5‑year+ horizons.
Establish a cohesive end‑to‑end CPI operating model that integrates people, process, technology, and vendor capabilities across the full claim lifecycle.
Serve as the single point of strategic coordination for initiatives combining multiple CPI teams and capabilities.
Document and maintain a clear CPI strategic roadmap, ensuring cross‑functional alignment across DDAT, ACS, Reporting, Finance, Procurement, Operations, and other stakeholders.
Create and manage governance forums, operating cadences, and decision frameworks to keep workstreams aligned while balancing transformation with day‑to‑day operational performance.
The Claims Data Research Analyst is responsible for analyzing claims data, identifying trends, investigating data discrepancies, and providing actionable insights to support claims operations, underwriting, finance, and executive leadership.
Compensation
The base salary range for this position is $80,000- $100,000 annually.
Responsibilities
Analyze claims data from multiple systems to identify trends, patterns, and anomalies
Develop and maintain dashboards, reports, and scorecards using tools such as Power BI, Excel, and SQL
Monitor key claims performance metrics, including claim volume, severity, closure rates, and cycle times
Perform root cause analysis on data inconsistencies and reporting variances
Research and investigate claim-level discrepancies across source systems
Requirements
Bachelor's degree in Data Analytics, Business, Finance, Mathematics, Statistics, Information Systems, or a related field
Lead the end-to-end claims management process across the operation centre, including claim intake, review, tracking, and resolution.
Locations (2)
Hong Kong, Hong Kong
Kuala Lumpur, Kuala Lumpur, Malaysia
Responsibilities
Assist to monitor and manage progress of P&C claims to settlement
Support our clients in providing insurers with all documentation and information required for the settlement of claims and liaise with clients as necessary
Provide advice to clients on claims procedure
Provide prompt response to client’s enquiries
Liaise with service providers to ensure claims are properly handled
Requirements
University or college graduate; business, insurance, legal or other relevant degree preferred
Lead the end-to-end claims management process across the operation centre, including claim intake, review, tracking, and resolution.
Locations (2)
Hong Kong, Hong Kong
Kuala Lumpur, Kuala Lumpur, Malaysia
Responsibilities
Assist to monitor and manage progress of P&C claims to settlement
Support clients in providing insurers with all documentation and information required for the settlement of claims and liaise with clients as necessary
Provide advice to clients on claims procedure
Provide prompt response to client’s enquiries
Liaise with service providers to ensure claims are properly handled
Requirements
University or college graduate
business, insurance, legal or other relevant degree preferred
Lead, coach, mentor, and develop a team of claims professionals across a portfolio of general insurance claims in Singapore, overseeing regional and global escalated claims and ensuring compliance and process improvements.
Responsibilities
Lead, coach, mentor, and develop claims professionals
Set individual and team targets based on capability, claims inflow, portfolio complexity, utilization, and departmental needs
Oversee operational matters of the offshore COE team supporting claims administration, management, data integrity and reporting
Act as the primary escalation point for all regional and global claims
Allocate and prioritize workloads to meet deadlines, client commitments, and operational deliverables
Requirements
Nice to have: broad experience across general insurance claims
Nice to have: experience handling escalated claims
Nice to have: experience negotiating with insurers
Nice to have: experience driving process improvements
Nice to have: experience supporting regional/global real estate and manufacturing clients
Lead the enterprise provider data management function, overseeing credentialing, network participation, data quality, and regulatory compliance across the organization.
Compensation
Pay Range: $149,882.00 - $224,823.00
Responsibilities
Lead the enterprise provider data management function and establish governance frameworks supporting data quality, data stewardship, and operational excellence.
Ensure provider demographic, credentialing, contracting, participation, reimbursement, and network data are maintained accurately across all source systems and downstream platforms.
Establish data ownership, controls, audit processes, and policies governing provider information throughout the provider lifecycle.
Develop and monitor key performance indicators (KPIs), service level agreements (SLAs), and quality metrics related to provider data operations.
Drive continuous improvement initiatives focused on automation, process optimization, data quality improvement, and operational efficiency.
Requirements
Bachelor's degree in Healthcare Administration, Business Administration, Health Informatics, Information Systems, or related field.
Master's degree in Healthcare Administration, Business Administration, Health Informatics, Information Systems, or related field.
Nice to have: NCQA accreditation requirements
Nice to have: CMS regulations
Manager, Claims Strategy & Operations Governance
SAN JOAQUIN COUNTY HEALTH COMMISSION · Posted Nov 11, 2026
Manages the development and lifecycle of technology products, including software, hardware, and services, overseeing multiple concurrent implementations while maintaining alignment with enterprise priorities.
Compensation
Base salary range: $92,400 to $159,133 annually
An annual employee bonus program
Responsibilities
Manages, plans and coordinates the development of new products, enhancements of existing products and technical solutions based on short-term and long-term needs
Lead end to end project implementation for business needs
Understands business unit operations and identifies opportunities to leverage technology to increase efficiency or effectiveness
Oversee multiple concurrent implementations, ensuring consistent delivery quality, governance, and alignment across workstreams
Partner with Product Owners to refine backlogs, prioritize features, and translate business needs into actionable IT requirements
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