- Terumo Medical Corporation (Somerset, NJ)
- …State transparency reporting obligations, and measuring the effectiveness of the compliance program . The Senior Compliance Manager -Monitoring & Transparency ... Sr . Compliance Manager - Monitoring &...senior management to create efficiencies in the compliance program and track its effectiveness. Develops insightful dashboards and… more
- Elevance Health (Woodbridge, NJ)
- …the Possibilities. Make an Extraordinary Impact.** **Title** : Pharmacist Clinical Sr . **Location(s):** Candidates must reside within 50 miles or 1-hour commute ... each way of an Elevance Health office (PulsePoint). The **Pharmacist Clinical Sr .** is responsible for developing and implementing pharmacy programs. **How you will… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Clarifying ambiguous or conflicting documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate patient status based on ... length of stay, level of care requirements and Medicare regulations, and Major Complications or Comorbidities (MCC) / Complications or Comorbidities 5. (CC)… more
- CVS Health (New York, NY)
- …in new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products ... Medicare plans within the Market. + Direction of senior leaders of specific functional areas as assigned. Functional...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Senior Manager Patient Services Hub Operations Date: Feb 20, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: ... people to make a difference with. **The opportunity** The Senior Manager , Patient Services Hub Operations seeks...among Insurers, PBMs, and Specialty Pharmacies including Medicaid and Medicare . + Ability to work with senior … more
- Centene Corporation (New York, NY)
- …enhance member and provider experience, while driving financial performance of the program . Works with Market and Shared Services stakeholders to achieve Market and ... $1 billion, respectively. + Executively manages APP with more than 165,000 Medicare members and annualized revenue totaling $2.2+ billion, representing 15%+ of the… more
- Elevance Health (Woodbridge, NJ)
- …member-centered, lasting pharmacy care. The ** Senior Test Lead (Business Change Manager Senior )** will be responsible for working with management to identify ... ** Senior Test Lead - Pharmacy Benefit Manager...you will make an impact:** + Manage relationships with project/ program stakeholders (IT and business). + Develop and implement… more
- VNS Health (Manhattan, NY)
- …CFEEC scheduled dates and outcomes as needed. * Offers assignment of Medicare assistance as needed. * Responds to inquiries regarding pre-enrollment issues, ... eligibility and program information to ensure service satisfaction. Works with our...for new enrollees start of care authorizations and care manager assignment. * Assists in the monitoring and updating… more
- Molina Healthcare (New York, NY)
- …the severity of illness and the site of service. This position will support our Senior Whole Health business. Senior Whole Health by Molina is a Managed ... or disabled people who are eligible for Medicaid and Medicare . We are looking for Case Managers with a...Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or master's degree in a social… more
- Atlantic Health System (Morristown, NJ)
- Responsible for leading and implementation program that supports non-physician clinical staff with orientation and competency assessment in order to promote ... measure the effectiveness of patient care. 4. Works with senior leadership, interdisciplinary teams and other stakeholders in order...of AllSpire Health Partners. We have received awards and recognition for the services we have provided to our… more
- Molina Healthcare (New York, NY)
- **Job Description** **Job Summary** The Provider Engagement Manager implements Health Plan provider engagement strategy to achieve positive quality and risk ... meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using… more
- CVS Health (Bronx, NY)
- …medical costs, and provides an unmatched experience for adults on Medicare in medically underserved communities. By providing holistic, comprehensive and integrated ... the care team and outreach team for questions regarding medicare and eligibility. PRMs are key players during Open...Other duties as assigned This role reports to the Manager of Care Services and has significant opportunity for… more
- New York State Civil Service (Brooklyn, NY)
- …3, Dietitian 2, Habilitation Specialist 2, Infection Control Nurse, Intermediate Care Facility Program Manager 1, Intermediate Care Facility Program ... Senior Physical Therapist, Senior Recreational Therapist (and all parenthetics), Senior Speech and Hearing Therapist, Social Work Assistant 3, Speech … more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity ... documentation e. Target DRGs Reviews f. Use of case manager as a resource + Uses guidelines to evaluate...on length of stay, level of care requirements and Medicare regulations, and Major Complications or Comorbidities (MCC) /… more
- Mount Sinai Health System (New York, NY)
- …risk adjustment for all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report to Vice President, Clinical ... Health Practice Optimization Lead (working collaboratively with a Population Health Manager (PHM)) for 6-10 high priority primary care/multispecialty practices. *… more
- VNS Health (Manhattan, NY)
- …+ Completes, reports including Key Volume Drivers, schedule of Accounts Receivable, Program Highlight (Actual vs. Budget) and A/R monthly Aging report. + Works ... with Manager to financially plan for new programs by addressing...references in year-end audit. + Provides analytical support to Senior Financial Management and other Finance staff, as needed.… more