- Lundbeck (New York, NY)
- …the region boundary Injectable/infusion sales experience within a buy & bill Medicare Part B/ Medical benefit environment or other comparable reimbursement ... and transform lives. Join us on our journey of growth!BioPharmaceutical Regional Business Director - East Will consider candidates who live in region or state which… more
- Humana (Trenton, NJ)
- …analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides ... caring community and help us put health first** The Medical Director relies on medical ...Prefer Medicaid experience + Utilization management experience in a medical management review organization, such as Medicare … more
- CVS Health (Trenton, NJ)
- … Medicaid Services) requires regulatory changes during the plan year. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** ensures accountability for ... Individual general enrollment, Special Needs Plans (SNP) and Employer Groups. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** acts as the… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Trenton, NJ)
- …community and help us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical ... necessity of a given service, level of care, or medical item/supply. The Medical Director 's...experience + Knowledge of the managed care industry including Medicare or Medicaid products + Possess analysis and interpretation… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- RWJBarnabas Health (Oceanport, NJ)
- …cost reports filings. In partnership with the Vice President of Corporate Reimbursement, the Director will manage the completion of DSH, Medicare Bad Debts, Wage ... Director , Corporate Reimbursement (Hybrid/Remote) - Oceanport, NJReq #:0000180233...as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment… more
- Molina Healthcare (New York, NY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Evolent (Trenton, NJ)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Trenton, NJ)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Mount Sinai Health System (New York, NY)
- …environments * Seek to improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1) be responsible ... to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- Humana (Trenton, NJ)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Evolent (Trenton, NJ)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Genetic Testing you will be a key member of the utilization ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior Director of Emergency Management Planning and Development is an expert in current federal, state, local, and non-governmental ... possesses a general knowledge of healthcare operations. The Senior Director is a key member of the Mount Sinai...US Dept of Health and Human Services Center for Medicare and Medicaid Services (CMS). + Interacts with emergency… more
- Evolent (Trenton, NJ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** Are you ... beyond the bedside? Evolent Health is seeking an **Associate Medical Director - Cardiovascular Medicine** to play...or disciplinary actions by **state or federal healthcare programs ( Medicare , Medicaid, OIG, or GSA).** Join us at **Evolent… more
- Humana (Trenton, NJ)
- …our caring community and help us put health first** The Associate Director - Value-based Specialty and Vendor Support role builds templates, standard documentation, ... case studies, and disseminates best in class knowledge. The Associate Director requires a solid understanding of how organization capabilities interrelate across… more
- NASCO (Trenton, NJ)
- **Overview** As Executive Director , Compliance you will lead and provide oversight and management of Compliance and Privacy functions and serve as the company's ... Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship responsibility… more
- Ascendis Pharma (Princeton, NJ)
- …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 ... and develop their skills. Ascendis Pharma is looking to hire an Associate Director , Rebate and Contract Operations to join our team. Responsibilities will include… more
- Humana (Trenton, NJ)
- …will join the Health Quality and Stars (HQS) leadership team as the Director , Competitive Intelligence to drive the strategic vision of the company's Stars ... Ratings. The ideal candidate will possess a deep understanding of the Medicare landscape, strong analytical skills and the ability to communicate insights… more
- Lundbeck (New York, NY)
- …region boundary + Injectable/infusion sales experience within a buy & bill Medicare Part B/ Medical benefit environment or other comparable reimbursement ... BioPharmaceutical Regional Business Director - East Requisition ID: 6150 Location: New...distinct geographical region. The product portfolio currently includes both medical benefit and specialty distribution for infusion therapy. The… more
