- Molina Healthcare (New York, NY)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (Trenton, NJ)
- …largest CVS Health PBM clients. The Medicare Business Analytics - FEP - Sr . Manager provides technical, analytical and business support for the FEP Account ... team. The role serves as the authority for FEP program data analytics, trend analysis, contractual guaranteed financial metrics,...the Medicare Business Analytics - FEP - Sr . Manager incorporates these into all aspects… more
- Gilead Sciences, Inc. (Manhattan, NY)
- …that will improve the lives of patients with life-threatening illnesses worldwide. The ** Sr .** **Field Reimbursement Manager - HIV Prevention (** ** Sr . ... in navigating the complexities of the healthcare system. The Sr . FRM HIV Prevention will provide in-person and virtual...and reimbursement outcomes. + Assist the internal patient support program team in enhancing hub and FRM processes, such… more
- Elevance Health (Woodbridge, NJ)
- …Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- Cardinal Health (Trenton, NJ)
- …receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **_Responsibilities_** The Case ... Manager supports patient access to therapy through Reimbursement Support...therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is… more
- Prime Therapeutics (Trenton, NJ)
- …and drives every decision we make. **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior Contract Representative is ... years of comprehensive experience working with Rebate contracts, or within Medicare /Medicaid (eg insurance, government program operations, managed care… more
- CVS Health (New York, NY)
- …and affordable. **Position Summary** CVS Health is looking for a technical product manager to join the Multi-Carrier Solutions team, an exciting and fast-paced new ... growth area within the organization. As a technical Product Manager & Adobe Target Developer, you will lead the...every day * MBA or other relevant graduate degree Medicare experience is a plus, not required **Education** Bachelor's… more
- Molina Healthcare (New York, NY)
- …Please include this experience on your resume.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Interventions / QI Compliance contributes to one ... + Acts as a lead specialist to provide project-, program -, and / or initiative-related direction and guidance for...results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may… more
- CVS Health (Trenton, NJ)
- …within network as well as other business areas (clinical, operations, Medicare segment). **Required Qualifications** + Successful project management experience in ... increasingly more complex projects across a highly-matrixed organization + Project/ program expertise in stakeholder facilitation, communications and relationship management… more
- Humana (Trenton, NJ)
- …communications and be well-versed in current channel trends and best practices. As the Senior Marketing Campaign Manager , you will work with a diverse team of ... first** Humana's Marketing organization is seeking an experience Marketing Campaign Manager to join the Acquisition Email Marketing team working remote anywhere… more
- CVS Health (Trenton, NJ)
- …to make health care more personal, convenient and affordable. **Position Summary** The Senior Manager , Strategic Planning will sit in the Network Performance & ... with a wide array of stakeholders, including those who are much more senior , to collect information, drive consensus, and develop recommendations + Research and… more
- Prime Therapeutics (Trenton, NJ)
- …vision, depth perception and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the ... fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The … more
- Prime Therapeutics (Trenton, NJ)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Clinical Program Manager - Remote **Job Description** The Clinical Program ... and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations...Structure** + Reports to Sr Principal or Sr Director in the Clinical Program Management… more
- Cardinal Health (Trenton, NJ)
- …+ Pharmacy benefits management experience preferred with specific knowledge of Medicare , Medicaid and commercially insured payer common practices and policies, ... and internal customers, create and complete applications for enrollment within program timeframes, review forms and supporting documentation thoroughly for any… more
- BAYADA Home Health Care (Manchester, NJ)
- …services under the Medicare Part B benefit. The foundation of the program is exceptional clinical care and relationship management as BAYADA clinicians become a ... dedicated **Registered Nurses, RN** to join our **Ocean County Senior Living** team. This office works with **clients in...to its clients, including traditional home care under the Medicare Part A benefit, as well as outpatient therapy… more
- CenterWell (Trenton, NJ)
- …part of our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health ... outcomes with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the… more
- Humana (Trenton, NJ)
- …help us put health first** Humana's Marketing organization is seeking a Senior Business Intelligence Engineer, Measurement Strategy & Marketing Performance to join ... market trends, and campaign performance. **Key Role Functions** + Works with Campaign Manager and Campaign Strategy roles to define the measurement approach for each… more
- VNS Health (Manhattan, NY)
- …CFEEC scheduled dates and outcomes as needed. * Offers assignment of Medicare assistance as needed. * Responds to inquiries regarding pre-enrollment issues, ... eligibility and program information to ensure service satisfaction. Works with our...for new enrollees start of care authorizations and care manager assignment. * Assists in the monitoring and updating… more
- VNS Health (Manhattan, NY)
- …CFEEC scheduled dates and outcomes as needed. + Offers assignment of Medicare assistance as needed. + Responds to inquiries regarding pre-enrollment issues, ... eligibility and program information to ensure service satisfaction. Works with our...for new enrollees start of care authorizations and care manager assignment. + Assists in the monitoring and updating… more
- VNS Health (Manhattan, NY)
- …moderately complex issues from other departments. + Escalates issues to manager as needed. Performs various administrative support functions (eg, generating/sending ... an institution, Home Care or Managed Long Term Care Program required + Knowledge of federal and state health...of federal and state health care regulations related to Medicare , Medicaid, managed care, and long term care preferred… more