• Senior Pharmacy Claims

    Humana (Trenton, NJ)
    …by driving meaningful impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional , you will play a crucial role ... Join us and lead the development of solutions that make a meaningful difference The Senior Pharmacy Claims Professional will play a pivotal role in … more
    Humana (01/25/25)
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  • Senior Investigator, Special Investigative…

    CVS Health (Trenton, NJ)
    …from home anywhere in the United States. We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Researches and… more
    CVS Health (01/18/25)
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  • Sr Analyst, Performance Suite Analytics

    Evolent (Trenton, NJ)
    …and articulating our value.** **Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on ... (health administration, epidemiology, public health, biology)- Required.** **1-3 years of professional experience in claims -based healthcare analytics with a… more
    Evolent (01/28/25)
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  • Cognos Framework Manager - Remote

    Prime Therapeutics (Trenton, NJ)
    …operations systems, particularly those that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, ... considering the business needs and direction. Experience serving as the senior member on business intelligence or analytics/data warehousing projects with… more
    Prime Therapeutics (01/28/25)
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