- Trustmark (Trenton, NJ)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to...member PHI / HIPAA information + This is a remote position\#LI- Remote **Scheduled Weekly Hours** 40 **Pay… 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 ... to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure...around the world. This position is currently classified as " remote " in accordance with Takeda's Hybrid and Remote… more
- EPAM Systems (Philadelphia, PA)
- …be the perfect opportunity for you to join EPAM as a **Managing Director , Insurance Advisory** . Scroll down to learn more about the position's responsibilities ... operational capabilities **Requirements** + Prior experience as a Managing Director (Partner, or equivalent level) with primary client relationship responsibility… more
- IQVIA (Wayne, PA)
- …capabilities to a health plan: data & analytics, interoperability, claims processing, population health.** + Exemplary interpersonal, relationship building, ... negotiations, and professional skills. + Confident, assertive, results driven, strong organizational skills and self-motivated, self-starter. + Must be self-motivated, have the internal drive to keep calling even when not getting traction immediately and have… more
- HealthEdge Software Inc (Trenton, NJ)
- **Overview** ** Director , Product Management** **Position Overview:** We are seeking a highly skilled and experienced Director of Product Management to lead our ... and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream… more
- Educational Testing Service (Trenton, NJ)
- …education and ed tech space as it continues to grow and evolve. The Executive Director of Learning Design will lead the strategy for how ETS develops learning and ... assessment solutions in the K16 Business Unit. The Executive Director will lead a team of learning scientists, instructional designers, user experience research and… more
- Merck (North Wales, PA)
- **Job Description** Reports to the Director /Senior Director in the Office of Promotion and Advertising Review (OPAR) The Associate Director is responsible ... regulatory team meetings to ensure support for anticipated promotional messages and claims (aligned with marketing strategy) in clinical trial design and product… more
- Bristol Myers Squibb (Princeton, NJ)
- …lives. Read more: careers.bms.com/working-with-us . **Position:** Associate Director , Medical Promotional Review Scientist, Neuropsychiatry **Location:** Princeton ... Pike, NJ or Madison, NJ The Associate Director , Medical Promotional Review Scientist plays a critical role...+ Determine acceptability of data/references used to support promotional claims and provide expert guidance as well as effective… more
- Humana (Trenton, NJ)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- RELX INC (Philadelphia, PA)
- Director of Data Content and Strategy About the business: LexisNexis Risk Solutions is the essential partner in the assessment of risk. Within our Healthcare ... and experienced professional to join our team as the Director of Data Content and Strategy. This critical role...Maintaining a deep understanding of relevant industry data, including claims , provider data, and patient insights. + Performing all… more
- Prime Therapeutics (Trenton, NJ)
- …decision we make. **Job Posting Title** Senior Data Visualization Consultant - Remote **Job Description** The Senior Data Visualization Consultant is responsible for ... new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
- Merck (North Wales, PA)
- …plus. . Strong knowledge of various pharmaceutical data sources, including patient claims data from IQVIA, sales force activity data, physician prescription data, ... by site or organization, with Friday designated as a remote -working day, unless business critical tasks require an on-site...not apply to roles that have been designated as " remote ". **San Francisco Residents Only:** We will consider qualified… more
- Prime Therapeutics (Trenton, NJ)
- …and drives every decision we make. **Job Posting Title** Data Scientist- REMOTE **Job Description** The Principal Data Scientist is an independent statistical ... program impact measurement using eligibility, medical, and pharmacy administrative claims and external data, (eg, care management, disease management, laboratory,… more
- Prime Therapeutics (Trenton, NJ)
- …Posting Title** Senior Compliance Analyst (Regulatory Compliants & Inquires) - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Works independently to research and resolve regulatory inquiries/complaints related to claims , contracting and XXXX. Works directly with business partners across the… more
- Prime Therapeutics (Trenton, NJ)
- …every decision we make. **Job Posting Title** Treasury Reporting Principal - Remote **Job Description** The Treasury Analyst Principal is responsible for managing, ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more
- Prime Therapeutics (Trenton, NJ)
- …every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible for leading portions ... Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations, Paper Claims , Member Materials, IT, etc.) to ensure effective collaboration,… more
- Nestle (Bridgewater, NJ)
- …future of health and nutrition for patients and consumers. Reporting to the Director of Compliance, the Manager, Pharma Compliance is responsible for supporting the ... Develop, administer, and maintain NHSc Pharma's Compliance Program in conjunction with Director of Compliance. + Create and execute a Compliance Training Program,… more
- St. Luke's University Health Network (Allentown, PA)
- …coding conventions, UHDDS guidelines and CMS directives. Researchs failed claims , identifies discrepancies and communicates resolution to appropriate departments. ... and/or physician queries + Serves as liaison between Physician Advisor/Medical Director , Finance, Utilization Review Department and CDCI. PHYSICAL AND SENSORY… more
- Zurich NA (Trenton, NJ)
- …AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR #LI-HYBRID ... Zurich's Philadelphia office. We are also open to hiring remote talent. This role will be filled at either...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more