- Merck & Co. (North Wales, PA)
- …the Director/Senior Director in the Office of Promotion and Advertising Review (OPAR)The Associate Director is responsible for the review and approval of all US ... regulatory team meetings to ensure support for anticipated promotional messages and claims (aligned with marketing strategy) in clinical trial design and product… more
- Lincoln Financial Group (Trenton, NJ)
- …**Requisition #:** 72954 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... Group Protection in a remote environment. Background Details The Claimant Excellence Team will...development to perform in this fast-paced environment. As a Claims Customer Care Associate , you… more
- BAYADA Home Health Care (Pennsauken, NJ)
- BAYADA Home Health Care is seeking a Healthcare Medical Collections Associate to join our **Home Health Reimbursement Services** team. Are you looking for an ... your career and learn the business? Then the Reimbursement Associate position might be right for you! **This is... position might be right for you! **This is REMOTE position** . Qualified candidates must be able to… more
- Prime Therapeutics (Trenton, NJ)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Customer Care Associate I - Remote **Job Description Summary** This position is ... Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities… more
- Takeda Pharmaceuticals (Trenton, NJ)
- …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Fresenius Medical Center (Malvern, PA)
- …within the assigned function(s). + Review, investigate and resolve outstanding claims in coordination with cross-divisional teams and/or vendors to obtain the ... of management. EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Fresenius Medical Care North America maintains a drug-free workplace in accordance… more
- The Cigna Group (Trenton, NJ)
- …IT, and other eviCore healthcare team members and departments. The Associate Analyst investigates client and provider issues, recognizes root-causes, and ... platforms that contain provider data, member information, authorizations, and claims . Must maintain proficiency in all technical applications, technical skills,… more
- Guardian Life (Bethlehem, PA)
- **Job Overview** The Client Manager Associate will assume overall responsibility for managing a client book of business in the 2-99 life space. They will be ... internal partners. These partners include Underwriting, Sales Support, Service, and Claims . This position will also directly work with Sales Representatives to… more
- Takeda Pharmaceuticals (Exton, PA)
- …true to the best of my knowledge. **Job Description** Join Takeda as an Associate Director, US Advertising & Promotion Regulatory Review out of our Lexington, MA or ... + Provide product development and label development strategies to ensure promotional claims can be supported. + May provide management of individuals including… more
- Merck (North Wales, PA)
- …Director/Senior Director in the Office of Promotion and Advertising Review (OPAR) The Associate Director is responsible for the review and approval of all US ... meetings to ensure support for anticipated promotional messages and claims (aligned with marketing strategy) in clinical trial design...or BS degree with an emphasis in science, health care or related fields. + Preferred: Master's, PhD or… more
- J&J Family of Companies (Horsham, PA)
- Associate Director, Signal Detection Scientist - 2406212640W **Description** Johnson and Johnson is currently seeking an ** Associate Director, Signal Detection ... NJ; Raritan, NJ; Horsham, PA; OR High Wycombe, UK. Remote work options in the US or UK may...international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and… more
- Humana (Trenton, NJ)
- …operational efficiency, reduce manual processes, and improve accuracy in insurance claims processing, policy management, and other key areas. A strong background ... solutions to streamline and automate insurance-related processes, such as claims processing, policy administration, and customer service operations. + **Technical… more
- Humana (Trenton, NJ)
- …for an experienced medical coding auditor to (suggest: review inpatient hospital claims for proper reimbursement) handle provider disputes in a result-oriented and ... payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments....**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Humana (Trenton, NJ)
- …**Use your skills to make an impact** **Required Qualifications** + A minimum of an Associate 's Degree + 5 or more years of experience in medical auditing & coding ... 6 or more years of work experience related to claims with an understanding claims lifecycles/healthcare revenue...team of offshore associates **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring… more
- Humana (Trenton, NJ)
- …health first** Humana's Clinical Analytics Team is seeking a Research Scientist 2 ( Remote ). Healthcare is rapidly changing, and our members are living longer, often ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
- Humana (Trenton, NJ)
- …must have an active compact (Multistate) license and experience in Behavioral Health. #LI- Remote This is a Full-Time, Remote Telephonic RN opportunity, however ... Assess discharge plans + Review and extract information from claims + Complete documentation for Quality Reviews for Peer...to make an impact** **Required Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse (RN) licensure… more
- Humana (Trenton, NJ)
- …populations served in target growth markets. **Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions for key ... Medicaid programs and subpopulations.** Areas of focus include Care Management, Quality Improvement, Utilization Management, Population Health, Social Determinants… more
- Humana (Trenton, NJ)
- …to work within the process parameters to help make connections with health care providers that will guide our members' treatment and ensure medication safety. ... **Location:** Remote Nationwide **Shift:** 9AM-5:30 PM Eastern Monda-Friday The Rx...problem-solving skills **Preferred Qualifications** + Previous experience with pharmacy claims + Previous experience performing pharmacy data entry +… more
- Humana (Trenton, NJ)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Trenton, NJ)
- …and/or Medicaid health plan operations, such as provider relations, claims submission and payment, utilization management processes, behavioral health processes, ... + **Travel** : Up to 5%, possibly out of your home state. + **Workstyle:** Remote , must work hours within the eastern time zone. + **Core Workdays & Hours:**… more
