- Hunterdon Health Care System (Flemington, NJ)
- This is an in-person role. Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- Norstella (Trenton, NJ)
- Client Success Renewals Specialist Company: MMIT Location: Remote, United States Date Posted: Dec 22, 2025 Employment Type: Full Time Job ID: R-978 **Description** ... and responsive to patient needs. **The Role:** The Client Success Renewals Specialist works in collaboration with the Client Success Operations Manager and Client… more
- Oracle (Trenton, NJ)
- …Manager and the roles within the pods (eg, Business Analyst, Integration Specialist , QA, etc.) and contribute to strategic planning, direction, and goal setting ... procedures, contractual budgets, providing expert-level insight on the development, utilization , and revision of contractual agreements. + Maintains customer… more
- J&J Family of Companies (New Brunswick, NJ)
- …Description:** We are searching for the best talent for a Neuroscience Sales Specialist to cover the New Brunswick territory, including Levittown, PA, Trenton, NJ, ... of the way. Learn more at https://www.jnj.com/innovative-medicine **The Neuroscience Sales Specialist will:** + Drive demand generation of Invega through clinical… more
- Eliassen Group (Trenton, NJ)
- …analyze requirements. + Provide expert advice on best practices for Workfront utilization . + Conduct/participate in regular meetings to review project progress ... **Workfront Configuration Specialist ** **Anywhere** **Type:** Contract **Category:** Development **Industry:** Insurance **Workplace Type:** Remote **Reference ID:**… more
- St. Luke's University Health Network (Quakertown, PA)
- …mental health/crisis intervention experience required. Previous experience with case management/ utilization review and managed care models preferred. Please ... may require treatment with seclusion/restraints. + Supports the function of utilization management regarding pre-certification process for all intakes and consults.… more
- Evolent (Trenton, NJ)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... for the culture. **What You'll Be Doing:** Job Description **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
- SHI (Somerset, NJ)
- …NJ office location. **Role Description** + Change Request Coordination: Receive and review change requests, ensuring that the requisite information is provided and ... and facilitate communication during the implementation process. + Post-Implementation Review : Participate in post-implementation reviews to assess the success and… more
- CVS Health (Trenton, NJ)
- …the strategy to incorporate emerging trends (AI, automation) that enhance knowledge utilization . + Lead the migration to ServiceNow Knowledge Base - Oversee the ... knowledge content. Chair the Knowledge Management Governance Board to review content quality, lifecycle (updates/retirement), and incoming knowledge requests. Ensure… more
- ASM Research, An Accenture Federal Services Company (Trenton, NJ)
- …on the project in a senior administrator capacity. Considered a technical specialist in a variety of IT administrator disciplines. + Configure, monitor, and ... as needed (aside from on-call rotation). + Optimize system operations and resource utilization as well as perform system capacity analysis and planning. + Utilize… more