- Teva Pharmaceuticals (Parsippany, NJ)
- Director Medicaid - Remote Date: Dec 27, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 58940 **Who we ... market access strategies to maximize profitability and success across Medicaid accounts. The Director will lead efforts to ensure Teva stakeholders are abreast… more
- RWJBarnabas Health (Oceanport, NJ)
- Director , Corporate Reimbursement (Hybrid/ Remote ) - Oceanport, NJReq #:0000180233 Category:Professional / Management Status:Full-Time Shift:Day ... Reimbursement Location: SBC Corporation, Oceanport, Oceanport, NJ 07052 Job Overview: The Director will serve as a key resource to department leadership for… more
- Humana (Trenton, NJ)
- …part of our caring community and help us put health first** The Director , IT Portfolio Management for Enterprise Information Protection (EIP) develops and executes ... technology and innovation to improve and mature Humana's security posture. The Director develops and executes on programs defined to implement security controls,… more
- Mathematica (Trenton, NJ)
- …our benefits here: https://www.mathematica.org/career-opportunities/benefits-at-a-glance We are seeking a motivated * Director of Data Science* to lead a practice of ... some of our largest clients, including the Centers for Medicaid & Medicare Services (CMS) and other agencies. Most...lack of work. *Available Locations:* Washington, DC; Princeton, NJ; Remote #LI-AR1 # remote -usa We are an Equal… 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 ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The Corporate Medical ... Director works on problems of diverse scope and complexity...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
- CVS Health (Trenton, NJ)
- …for their clinical quality and effective use of health care resources. **This is a remote based (work from home) role and m** **ust have a California medical license ... Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy implementation.… more
- Alternatives, Inc. (Raritan, NJ)
- …illnesses. The Community Outreach Services Department is currently seeking a Director of Community Outreach Services. ESSENTIAL DUTIES AND RESPONSIBILITIES: - ... communication skills. - Familiarity or prior experience with Fee-For-Service Medicaid environments is a plus. - Experience working with...commute to the main office in Raritan NJ, and remote , using Go To Meeting. All trainings are compensated.… more
- Vibrant Emotional Health (New York, NY)
- Job Title: Program Director Department: Youth and Family Wellness Reports To: Assistant Program Director Schedule: Monday to Friday, 9am to 5pm Location: ... Remote /Hybrid Flexed, cases in Manhattan, Bronx, Queens Pay Grade:...and the budgeted amount for the role. Clinical Program Director Vibrant (formerly the Mental Health Association of New… more
- Elevance Health (Woodbridge, NJ)
- **Process Improvement Director -HEDIS** **Location:** This position will work a hybrid model ( remote and office). Must reside within 50 miles/1hour commute from ... the posted Elevance Health locations. This **Process Improvement Director -HEDIS** will be responsible for enterprise HEDIS improvement and governance programs, with… more
- NYU Rory Meyers College of Nursing (New York, NY)
- Position Summary Reports to the Associate Dean of Clinical Administration. The Director of Dental Insurance Strategy is a visionary leader responsible for expanding ... as a leading provider of comprehensive dental care. Additionally, the Director will design and implement innovative self-pay payment strategies, providing patients… more
- City of New York (New York, NY)
- …Bureau of Human Resources seeks to hire an Administrative Manager, NM/L-III (Senior Director , Office of Compliance Services). DUTIES WILL INCLUDE BUT NOT BE LIMITED ... existing employees are cleared utilizing the local and federal Medicaid compliance (OMIG and HHS) databases. Reviewing tasks and...& BUDGET APPROVAL" "This position MAY be eligible for remote work up to two days per week, pursuant… more
- Humana (Trenton, NJ)
- …is one of the largest health benefits organizations in the country. **Location:** remote The Insurance Strategy team supports Humana's Medicare and Medicaid ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Mathematica (Trenton, NJ)
- …of data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and ... and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through… more
- Prime Therapeutics (Trenton, NJ)
- …**Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior Compliance Analyst assists in the ... or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must...focus **Reporting Structure** + Reports to Sr Professional, Manager, Director or Senior Director in the Compliance… more
- Molina Healthcare (New York, NY)
- …and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + Other tasks, duties, ... **Preferred Experience** + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. **Preferred License,… more
- Public Consulting Group (Trenton, NJ)
- …intersection and overlap between our Special Education/Case Management and school-based Medicaid services work within a state; regularly engage with counterparts + ... clients + Understand and continually monitor Federal, state, and local Medicaid School-Based program policies and guidance, collaborating with PCG subject matter… more
- Public Consulting Group (Trenton, NJ)
- …support the delivery of health-related services by helping schools access critical Medicaid reimbursement. Client Success Partners (CSP) are key members of the ... PCG services. This position may report to either a SBS COE Client Success Director or a Client Success Lead. **Duties and Responsibilities** _Clients_ + Own and… more
- Evolent (Trenton, NJ)
- …The CCO will lead the Clinical Operations team and work with medical director leadership to ensure consistent and efficient adjudication of clinical decisions. The ... the CCO will also have dotted line oversight over field medical director (FMD) operational responsibilities, provide strategic input into medical policy and advise… more
- VNS Health (Manhattan, NY)
- …that inform program management and committee decisions. * Work Flexibly: Enjoy a mostly remote work environment with just one day a month in the office, allowing you ... + Ensures regulatory compliance and timely processing for the Medicare and Medicaid appeal and grievance processes, incidents, quality of care concerns and any… more