- Merck & Co. (North Wales, PA)
- …Quantitative Sciences team uses big data to analyze the safety and efficacy claims of our potential medical breakthroughs. We review the quality and reliability of ... and high-quality data to support decision making in clinical trials.-The Associate Principal Scientist, Statistical Programmer supports the design, development, and… more
- Merck & Co. (North Wales, PA)
- …the Director/Senior Director in the Office of Promotion and Advertising Review (OPAR)The Associate Director is responsible for the review and approval of all US ... regulatory team meetings to ensure support for anticipated promotional messages and claims (aligned with marketing strategy) in clinical trial design and product… more
- 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)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient ... communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or… more
- Takeda Pharmaceuticals (Trenton, NJ)
- …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Merck (North Wales, PA)
- …Director/Senior Director in the Office of Promotion and Advertising Review (OPAR) The Associate Director is responsible for the review and approval of all US ... meetings to ensure support for anticipated promotional messages and claims (aligned with marketing strategy) in clinical trial design...or BS degree with an emphasis in science, health care or related fields. + Preferred: Master's, PhD or… more
- Merck (North Wales, PA)
- …Quantitative Sciences team uses big data to analyze the safety and efficacy claims of our potential medical breakthroughs. We review the quality and reliability of ... high-quality data to support decision making in clinical trials. The Associate Principal Scientist, Statistical Programmer supports the design, development, and… more
- Humana (Trenton, NJ)
- …**Use your skills to make an impact** **Required Qualifications** + A minimum of an Associate 's Degree + 5 or more years of experience in medical auditing & coding ... 6 or more years of work experience related to claims with an understanding claims lifecycles/healthcare revenue...team of offshore associates **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring… more
- Humana (Trenton, NJ)
- …for our members and providers, all while driving health outcomes and cost-effective care for our members. We are seeking a Clinical Investigation Lead to provide ... strategic direction to drive appropriate care , with the aim of reducing waste and overuse...to bring forth a pipeline of potential initiatives. **Location:** remote In this lead role you'll have the opportunity… more
- Humana (Trenton, NJ)
- …first** Humana's Clinical Analytics Team is seeking a Lead Research Scientist ( Remote ). Healthcare is rapidly changing, and our members are living longer, often ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
- University of Pennsylvania (Philadelphia, PA)
- …d) completing data use agreement, data reuse agreement, and business associate agreement applications, and liaising with external groups (eg, the Centers ... prescription drugs is strongly preferred. + Intermediate understanding of healthcare claims and electronic medical record data is strongly preferred. Intermediate… more
- Humana (Trenton, NJ)
- …populations served in target growth markets. **Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions for key ... Medicaid programs and subpopulations.** Areas of focus include Care Management, Quality Improvement, Utilization Management, Population Health, Social Determinants… more
- Humana (Trenton, NJ)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Trenton, NJ)
- …researches/reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or recovery. Analyzes, enters ... knowledge. **Use your skills to make an impact** **WORK STYLE:** 100% remote /work at home. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day,… more
- Humana (Trenton, NJ)
- …for complex accounts + Experience analyzing a wide variety of health or claims related data **Additional Information** **Why Humana?** At Humana, we know your ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more
