- Humana (Trenton, NJ)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Trenton, NJ)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- American Water (Delran, NJ)
- …of AW. This includes management of all workers' compensation and general liability claims across the business unit * Ensure that claims and accidents are ... we do at American Water. The *Health and Safety Director * is a statewide role that will be responsible...their duties which include training, auditing, accident investigations, database management and recordkeeping. * Interface with all levels of… more
- Humana (Trenton, NJ)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Merck (Trenton, NJ)
- …needs to support collaboration to further differentiate our portfolio. The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, ... **Job Description** Our Medical Affairs team advances patient care by engaging...and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs… more
- Cardinal Health (Trenton, NJ)
- …and delivers human resource programs and policies, including recruitment, talent management , diversity and inclusion, compensation and benefits, among others. This ... **_Job Summary_** We are seeking an experienced and strategic Director of US Benefits to lead and oversee the...Benefits to lead and oversee the design, implementation, and management of employee benefit programs. This role will be… more
- Taiho Oncology (Princeton, NJ)
- …Join our growing Medical Affair team in the role of Associate Director , Outcomes Research & RWE. Your expertise will play a pivotal role in advancing ... outcome research, applying methodology for evidence generation and program management . Position Summary: The Associate Director , Outcomes Research… more
- Ascendis Pharma (Princeton, NJ)
- …to be both strategic and tactical, demonstrating strong leadership, project management , and communication skills. As the Director , Contracting Operations, ... mission of developing new and potentially best-in-class therapies to address unmet medical needs. Our culture fosters a place where skilled, adaptable, and highly… more
- Intermountain Health (Trenton, NJ)
- **Job Description:** Reporting to the Senior Director of Revenue Integrity, the Revenue Integrity Director is responsible for directing and executing the ... Reconciliation, Revenue Guardian, and Claim Edits. The Revenue Integrity Director defines and carries out the strategy for maximizing...for you and your family. Our generous package includes medical , dental, and vision coverage. But health is more… more
- CVS Health (Trenton, NJ)
- …strategies. . Develops training sessions and communicates updates related to network management , utilization management , claims processing, and other ... **Position Summary** Provides strategic leadership and oversight for network management and provider relations. Develops and implements network strategies, manages… more
- Sedgwick (Trenton, NJ)
- …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Client Services Director - Casualty | Northeast Region **PRIMARY PURPOSE** : To determine… more
- Takeda Pharmaceuticals (Trenton, NJ)
- …plasma-derived therapies for patients with immunologic, hematologic, and other complex diseases. The Director , Global Labeling Strategy Lead is a key role in the PDT ... new TLP, CCDS, USPI and EU SmPC. **How you will contribute:** ** Management of Labeling Cross-Functional Teams** + Leads Labeling cross-functional teams providing… more
- Takeda Pharmaceuticals (Trenton, NJ)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Centene Corporation (Trenton, NJ)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... coding practices through a comprehensive review and analysis of medical claims , medical records, ...adjustments and miscellaneous/unlisted code review + Review cases with Medical Director to validate decisions and identify… more
- HomeSafe Alliance (Trenton, NJ)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- Mathematica (Trenton, NJ)
- …or APCD claims data; EHR and/or HIE data; healthcare informatics; medical coding). * Ability to describe difficult technical problems and solutions to a ... data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and… more
- Evolent (Trenton, NJ)
- …to both members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . ... and Oncology Heathcare experience/knowledge** + Minimum of one year of experience with medical management activities in a managed care environment + Excellent… more
- Virtua Health (Mount Laurel, NJ)
- …If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than ... billing, reducing compliance risks, and ensuring accurate and timely submission of claims to insurance companies. The position is responsible for root cause… more
- Kelly Services (Titusville, NJ)
- …academia, and/or consulting and various types of data eg, administrative claims , electronic health/ medical record, hospital billing preferred. + Experience ... + The candidate will do this in close partnership with the Director SPPH. + Collaborate with internal stakeholders to identify/share best practices regarding… more
- Legacy Treatment Services (Hainesport, NJ)
- …matter as appropriate. Key Responsibilities: + Initiates Workers Compensation claims , schedules employee treatment, clears any noted restrictions with employee's ... to ensure accuracy + Provides training to employees and/or management as needed on duties covered in position responsibilities...Assists employees with various HR related requests + Assists Director of HR and Vice President of HR as… more