- Elevance Health (Morristown, NJ)
- ** Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** Alternate locations may be considered. This position will work a hybrid model ... will live within 50 miles of our Elevance Health PulsePoint locations. The ** Director of Medicare Risk Adjustment Analytics and Reporting** is responsible for… more
- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… 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
- BAYADA Home Health Care (Livingston, NJ)
- **BAYADA** Home Health Care has an immediate opening for a ** Director ** to lead Medicare Certified services in Essex and Hudson Counties. This role requires an ... Health or health care management experience required. Knowledge of Medicare Conditions of Participation strongly preferred. _This position is...NJ and North Bergen, NJ._ **As a Home Health Director your day may look like this!** + Responsible… 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 ... develop their skills. Ascendis Pharma is looking to hire an experienced Director , Contract Operations to join our team. Responsibilities will include implementing… more
- New York State Civil Service (Staten Island, NY)
- …HELP No Agency People With Developmental Disabilities, Office for Title Deputy Director DDSO 2 Occupational Category Health Care, Human/Social Services Salary Grade ... innovative leader who can execute strategic decisions to serve as Deputy Director of the Developmental Disabilities State Operations Office in Region 5 (DDSOO… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Health System/Goryeb Children's Hospital is Seeking a Program Director for our Pediatric Residency Training Program located in Morristown, New Jersey The ... Health System, is a branch campus of Sidney Kimmel Medical College at Thomas Jefferson University. The role of...College at Thomas Jefferson University. The role of Program Director involves a commitment of 60% administrative responsibilities and… more
- Mount Sinai Health System (New York, NY)
- …is responsible for evaluating and driving performance for value-based contracts including Medicare , Medicaid and commercial arrangements. The Senior Director is ... including Powerpoint and Excel Results orientation with working knowledge of medical economics analytics Understanding of CMS programs and concepts (eg, Star… more
- Morrisview Healthcare Center (Morristown, NJ)
- …Healthcare Center - MorrisView Healthcare Center is looking for an A dmission s Director to join our incredible team! We're not just a workplace; we're a community ... for a rewarding career experience, your journey begins here! Shift Hours: Admissions Director Benefits: + Competitive wages based on experience + Daily pay option… more
- CVS Health (New York, NY)
- …and affordable. **Position Summary** The Web Channel Owner role for Aetna Medicare is a critical position in our Marketing organization, with accountability for ... shepherd the delivery of Digital Marketing's capabilities backlog for Aetna.com/ Medicare , AllinaHealthAetnaMedicare.com, the Shop, Buy, and Enroll tool, and more,… more
- Pfizer (New York, NY)
- ** Director , US Market Access Marketing Oncology, Sasanlimab and Mevrometostat** **ROLE SUMMARY** The incumbent, within the US Market Access Marketing (USMA-M) team, ... development of the Customer/Brand engagement strategy for top accounts within Commercial, Medicare , and other channels as appropriate based on clinical and economic… more
- City of New York (New York, NY)
- …position on Medicaid redesign policy and innovation. Advise and assist OSHSSA Executive Director , Chief Medical Officer and other agency executives on healthcare ... and clinicians. The Bureau of Equitable Health Services seeks to hire a Director of Healthcare Payment & Financing Initiatives. DUTIES WILL INCLUDE BUT NOT BE… more
- Elevance Health (Woodbridge, NJ)
- …care. CarelonRx's Pharmaceutical Rebates Org is looking to hire a ** Director , Formulary Strategy Development.** This high-performing individual contributor will play ... in driving affordability across multiple lines of business (Commercial, Medicaid, Medicare , ASO clients) by partnering with internal and external stakeholders to… more
- City of New York (New York, NY)
- …agency. The Department's main goal is to provide fire protection, emergency medical care, and other critical public safety services to residents and visitors ... Department, City of New York (FDNY), seeks a full-time Director , Risk Assessment & Accountability in the Office of...to augment the internal audit staff (eg, annual ambulance Medicare billing) - Liaison with external auditors. - Prepare… more
- Molina Healthcare (New York, NY)
- …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
- VNS Health (Manhattan, NY)
- …company holidays + Health insurance plan for you and your loved ones, Medical , Dental, Vision, Life Disability + Employer-matched retirement saving funds + Personal ... + Strong knowledge of Federal and state health care regulations related to Medicare , Medicaid, managed care, and long term care required CAREERS AT VNS Health… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary + Responsible for application and maintenance of medical necessity software, insuring compliance relating to Medicare billing requirements, ... internal audits relating to medical necessity, analyzing medical necessity denials, communicating and updating staff on changes...others by means of webinars and teleconferences offered by Medicare + General & Medicare Compliance: … more
- VNS Health (Manhattan, NY)
- …of individual grievances and appeals. Consults with enrollees, providers and the Medical Director , as appropriate. + Provides input and recommendations for ... operations and customer service. + Reviews information available from Medicaid, Medicare , other payers, and/or professional medical organizations regarding… more
- RWJBarnabas Health (Elizabeth, NJ)
- …onto Care medic system to obtain medical necessity compliance + Explains Medicare medical necessity guidelines to both physicians patients + Calls physicians ... #:0000181962 Category:Clerical / Administrative Support Status:Full-Time Shift:Night Facility:Trinitas Regional Medical Center Department:Emergency Dept Access Service Location: WILLIAMSON STREET,… more
- Penn Medicine (Plainsboro, NJ)
- …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... Are you living your life's work? Summary: + The Nurse Manger assists the Director in managing the daily operations of the department with direct responsibility of… more