• Sr Program Manager

    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
    Molina Healthcare (12/19/24)
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  • Sr Mgr, Medicare Business Analytics…

    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
    CVS Health (12/21/24)
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  • Sr . Field Reimbursement Manager

    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
    Gilead Sciences, Inc. (12/21/24)
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  • Sr Coordinator, Individualized Care (Case…

    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
    Cardinal Health (12/25/24)
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  • PBM Contract Representative Sr - LA…

    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
    Prime Therapeutics (12/19/24)
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  • Sr Specialist, Quality Interventions/QI…

    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
    Molina Healthcare (11/28/24)
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  • Manager , FP&A, Medicare /Medicaid…

    CVS Health (Trenton, NJ)
    …the strategic subject matter expert for all forecasting cycles with the approval of the Senior Manager and Health Plan CFO /CEO for reporting to the Enterprise ... make health care more personal, convenient and affordable. **Position Summary** As the Manager , FP&A, you will report directly to Director of Finance and will… more
    CVS Health (01/17/25)
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  • Manager , Process Improvement…

    Molina Healthcare (New York, NY)
    **Knowledge/Skills/Abilities** * Responsible for program development, implementation, and management of process improvement initiatives. * Coordinates, directs, and ... Conduct meetings and disseminates communication related to process improvement activities to senior leadership and staff as needed. * Knowledge of HEDIS measurement… more
    Molina Healthcare (01/13/25)
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  • Senior IT Portfolio Manager

    Humana (Trenton, NJ)
    …a part of our caring community and help us put health first** The Senior Portfolio Management Professional collaborates with the business portfolio team to align the ... IT portfolio and demand. The Senior Portfolio Management Professional work assignments involve moderately complex to complex issues where the analysis of situations… more
    Humana (01/16/25)
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  • Senior Marketing Campaign Manager

    Humana (Trenton, NJ)
    …and help us put health first** Humana's Marketing organization is seeking a Senior Professional experienced in marketing content and campaign planning to join the ... team. The Senior Marketing Campaign Management Professional reports directly to the...off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer… more
    Humana (01/15/25)
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  • Senior National VBC Performance…

    Centene Corporation (New York, NY)
    …enhance member and provider experience, while driving financial performance of the program . Works with Market and Shared Services stakeholders to achieve Market and ... $1 billion, respectively. + Executively manages APP with more than 165,000 Medicare members and annualized revenue totaling $2.2+ billion, representing 15%+ of the… more
    Centene Corporation (01/10/25)
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  • Senior Compliance Analyst (Interpretation…

    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 (12/17/24)
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  • Senior Individualized Coordinator (Case…

    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
    Cardinal Health (12/18/24)
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  • IT Program Manager (Remote Eligible)

    Mathematica (Trenton, NJ)
    …We are seeking a highly motivated person to join our team as an *IT Program Manager * in the Delivery Management practice in Health Solutions Insights. As an ... IT Program Manager , you will lead teams and...work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff working on CMS contracts… more
    Mathematica (01/05/25)
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  • Senior Enrollment Assistant, Bilingual…

    VNS Health (Manhattan, NY)
    …Medical, Dental, Vision, Life and Disability + Employer-matched 401k retirement saving program + Personal and financial wellness programs + Pre-tax flexible spending ... (FSAs) for healthcare and dependent care and commuter transit program + Generous tuition reimbursement for qualifying degrees +...dates and outcomes as needed. + Offers assignment of Medicare assistance as needed. + Responds to inquiries regarding… more
    VNS Health (01/07/25)
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  • Clin Prog Dev Manager (US)

    Elevance Health (Woodbridge, NJ)
    …**Responsible for monitoring quality performance data, and managing clinical program development for population-based clinical quality measures, focusing on HEDIS.** ... the strategies, programs and tools to be implemented. + Leads program development activities. + Develops and coordinates presentations, communications and… more
    Elevance Health (01/18/25)
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  • Nurse Manager - Full-Time, 7a-3p, Operating…

    Atlantic Health System (Morristown, NJ)
    Responsible for leading and implementation program that supports non-physician clinical staff with orientation and competency assessment in order to promote ... measure the effectiveness of patient care. 4. Works with senior leadership, interdisciplinary teams and other stakeholders in order...of AllSpire Health Partners. We have received awards and recognition for the services we have provided to our… more
    Atlantic Health System (01/11/25)
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  • Complex Care Program Delivery Operations…

    CenterWell (Trenton, NJ)
    …of our caring community and help us put health first** The Program Delivery Lead strategically identifies, develops, and implements programs that influence ... or market leadership towards value-based relationships and/or improved quality metrics. The Program Delivery Lead works on problems of diverse scope and complexity… more
    CenterWell (01/18/25)
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  • Behavioral Health Strategy Principal

    CenterWell (Trenton, NJ)
    …health outcomes for seniors, serving as a behavioral health (BH) strategy, program and operations expert, and advancing BH goals through innovative, data-driven ... position formulates national goals and strategies, benchmarks best practices, drives program design and implementation, evaluates program effectiveness, and… more
    CenterWell (01/14/25)
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  • Medical Director Physician Engagement and CDQI…

    Mount Sinai Health System (New York, NY)
    …risk adjustment for all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report to Vice President, Clinical ... Health Practice Optimization Lead (working collaboratively with a Population Health Manager (PHM)) for 6-10 high priority primary care/multispecialty practices. *… more
    Mount Sinai Health System (12/02/24)
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