• Medical Director -- Claims

    Humana (Trenton, NJ)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (10/29/24)
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  • Medical Director - Florida

    Humana (Trenton, NJ)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (12/14/24)
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  • Medical Director - National Medicare…

    Humana (Trenton, NJ)
    management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
    Humana (11/08/24)
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  • Director , Medical Affairs - NYC…

    Merck (Trenton, NJ)
    **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
    Merck (12/19/24)
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  • Director , Risk Management

    Western Digital (Trenton, NJ)
    …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
    Western Digital (12/27/24)
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  • Director , Health and Safety

    American Water (Delran, NJ)
    …of AW. This includes management of all workers' compensation and general liability claims across the business unit * Ensure that claims and accidents are ... we do at American Water. The *Health and Safety Director * is a statewide role that will be responsible...their duties which include training, auditing, accident investigations, database management and recordkeeping. * Interface with all levels of… more
    American Water (12/30/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Trenton, NJ)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (01/07/25)
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  • Director , Medicaid Trend Mitigation…

    Humana (Trenton, NJ)
    …functions strategy. + Establishes and oversees Medicaid segment trend mitigation strategy ( claims and revenue management ) + Researches industry trends and ... part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and… more
    Humana (01/08/25)
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  • Director of International, Global Household…

    HomeSafe Alliance (Trenton, NJ)
    **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
    HomeSafe Alliance (12/21/24)
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  • Director Healthcare Economics & Trend…

    Baylor Scott & White Health (Trenton, NJ)
    claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
    Baylor Scott & White Health (12/21/24)
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  • Client Services Director - Casualty…

    Sedgwick (Trenton, NJ)
    …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Client Services Director - Casualty | Northeast Region **PRIMARY PURPOSE** : To determine… more
    Sedgwick (01/04/25)
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  • Actuarial Director , Medicaid Trend…

    Humana (Trenton, NJ)
    …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
    Humana (01/03/25)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Trenton, NJ)
    …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
    Takeda Pharmaceuticals (10/16/24)
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  • Operations Supervisor - Move Management

    HomeSafe Alliance (Trenton, NJ)
    **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
    HomeSafe Alliance (01/01/25)
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  • Sales Administrator

    Fujifilm (Trenton, NJ)
    …Sales Administrator for Latin America and the Caribbean will report to the Director of Sales for ID/Optical Devices/ EID. The primary responsibility of this position ... be to support sales for Latin America and Caribbean accounts currently under management by FNAC. Achieve the division sales plan, provide weekly and monthly detail… more
    Fujifilm (01/07/25)
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  • Associate I, Reimbursement Collections

    BAYADA Home Health Care (Pennsauken, NJ)
    …Complete claim denial management functions to ensure timely follow-up with denied claims and complete root causes analysis to determine ways to prevent claims ... from denying. + Process balance transfers, adjustment requests, refunds and corrected claims as part of accounts receivable management responsibilities. +… more
    BAYADA Home Health Care (01/04/25)
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  • Attorney, Health Care In-House Litigation Support

    BAYADA Home Health Care (Pennsauken, NJ)
    …litigation support. They will manage high-risk professional and general liability claims , focusing on healthcare-related matters, with a smaller caseload of ... employment and miscellaneous legal issues. Supporting the Director of Legal Services and collaborating with the legal team, this role involves guiding defense… more
    BAYADA Home Health Care (12/05/24)
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  • Principal Client Solution Architect - State…

    Mathematica (Trenton, NJ)
    …or APCD claims data; EHR and/or HIE data; healthcare informatics; medical coding). * Ability to describe difficult technical problems and solutions to a ... 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… more
    Mathematica (01/04/25)
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  • AVP, Human Resources Business Partner

    SitusAMC (Trenton, NJ)
    …team! This role is responsible for aligning business goals with employees and management . The position should anticipate HR needs in a proactive manner and ... communicate these requirements and potential solutions to the management team. This position is the HR point of contact for management and employees for their… more
    SitusAMC (01/04/25)
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  • Revenue Cycle Integrity Analyst (Hybrid)

    Virtua Health (Mount Laurel, NJ)
    …If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than ... billing, reducing compliance risks, and ensuring accurate and timely submission of claims to insurance companies. The position is responsible for root cause… more
    Virtua Health (12/10/24)
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