• Physician Medical Director - LTSS

    Humana (Trenton, NJ)
    …work East Coast hours. Please see position requirements for licensing details.** The LTSS Reviewing Medical Director actively uses their medical ... how to operationalize this knowledge into their daily work. The LTSS Reviewing Medical Director 's work includes computer-based review of moderately complex… more
    Humana (01/25/25)
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  • Medical Director - National Medicare…

    Humana (Trenton, NJ)
    …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex...clinical standards, and (in some cases) contracts. Primary work reviewing prior-authorization reviews as well as some claims and… more
    Humana (03/11/25)
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  • Director , Medical Affairs Strategy…

    Sumitomo Pharma (Trenton, NJ)
    …. **Job Overview** The ** Director , Medical Strategy ... (Prostate Cancer)** will be a key member of the Medical Affairs team reporting to the Executive Director...**Key Core Competencies** + Strategic thinking, critical analysis and reviewing primary data to develop insights. + Ability to… more
    Sumitomo Pharma (01/25/25)
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  • Director , Long Term Strategic Planning

    Humana (Trenton, NJ)
    …of our caring community and help us put health first** The Director , Corporate Strategy, Long-Term Financial Planning oversees an organization's strategic and ... the development of long-term growth plans and profitability goals The Director , Corporate Strategy, Long-Term Financial Planning oversees an organization's strategic… more
    Humana (03/14/25)
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  • Medicare Benefits Standards & Guidance Lead…

    CVS Health (Trenton, NJ)
    …the plan year. The **Medicare** **Benefits Standards & Guidance Lead Director ** ensures accountability for the implementation, management, and maintenance of the ... Plans (SNP) and Employer Groups. The **Medicare** **Benefits Standards & Guidance Lead Director ** acts as the point of contact to our corporate partners, such as… more
    CVS Health (03/14/25)
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  • Director Client Services

    EFI Global (Trenton, NJ)
    …to learn more about EFI Global. **We are seeking a Client Services Director with experience in the insurance industry, specifically in executive general adjusting ... on issues and trends impacting programs. + Conducts pre-renewal visits reviewing client loss experience and general company performance. Reviews and identifies… more
    EFI Global (02/21/25)
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  • Director Strategic Sourcing & Procurement…

    Virtua Health (Marlton, 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 ... to extraordinary circumstances. Department operations: hiring and training of staff, reviewing and updating policies and procedures, oversight of procurement card… more
    Virtua Health (03/04/25)
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  • Outpatient Nurse Manager (Pediatrics) - Full Time

    RWJBarnabas Health (Toms River, NJ)
    …functions in the medical practices for children with special needs and medical complexity with assistance from the Director as needed. Works collaboratively ... staff, and colleagues both internal and external. Assures the medical practice(s) adheres to policies and procedures and regulations...at all interactions + Takes an active role in reviewing Press Ganey survey and performs follow-up + Responsible… more
    RWJBarnabas Health (01/15/25)
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  • Claims Manager - Liability - REMOTE

    Ryder System (Trenton, NJ)
    …Responsibilities + Performs other duties as assigned. + Primary backup for the Director assisting as directed with claim assignments, reviewing and tracking all ... claims as well as insurance and contractual coverage issues. Assists Director in the identification of exposures, recommends solutions, promotes loss prevention… more
    Ryder System (02/25/25)
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  • Assistant Nurse Manager - ICU

    Virtua Health (Voorhees, 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 ... 40 Additional Locations: Job Information: ICU experience requiredSummary:Assists Nurse Director / Manager in the coordination of the clinical/business activities… more
    Virtua Health (02/07/25)
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  • Manager, Quality Assurance

    Cardinal Health (Trenton, NJ)
    …**_Responsibilities_** + Primary focus will be supporting 3PL Partners within the Medical Segment. + Manages internal Quality Assurance policies and programs to set ... & Drugs Act, Good Manufacturing Practice, and a variety of regulations related to medical devices, natural health products, drugs, and consumer goods. + Leads a team… more
    Cardinal Health (03/04/25)
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  • Residential Manager

    PILOT SERVICES INC (Berlin, NJ)
    …and maintained in accordance with agency policy and procedure. + Review documentation from medical appointments to ensure medical needs are being met. + Ensure ... ISP meetings. + Ensure all DSPs are completing and reviewing the daily communication log. + Review and sign...assignments, activities, and tasks as delegated by the Associate Director of Residential Services. Qualifications + Applicants must be… more
    PILOT SERVICES INC (02/19/25)
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  • Attorney, Health Care In-House Counsel

    BAYADA Home Health Care (Pennsauken, NJ)
    …related litigation. A combination of in-house and firm experience with medical malpractice/professional liability claims is preferred. The **Senior Counsel, Legal ... with a smaller caseload of employment and miscellaneous legal issues. Supporting the Director of Legal Services and collaborating with the legal team, this role… more
    BAYADA Home Health Care (03/15/25)
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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 ... a Full-time Revenue Integrity Analyst. The role involves conducting charge audits, reviewing clinical charge capture workflows, and creating action plans to capture… more
    Virtua Health (03/11/25)
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  • Project Controls Manager II

    RES (Trenton, NJ)
    …the change management process. + Supports Subcontractor Change Management by reviewing subcontractor changes and assessing impact to overall budget and forecast. ... project execution plan. **Assists with Client Relationship Management:** + Assists Construction Director and Project Manager in client negotiations as they relate to… more
    RES (02/04/25)
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