• Medicare Medical Director

    Elevance Health (Morristown, NJ)
    ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
    Elevance Health (01/08/25)
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  • Medical Director

    Molina Healthcare (New York, NY)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (12/26/24)
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  • Medical Director Physician…

    Mount Sinai Health System (New York, NY)
    …environments * Seek to improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1) be responsible ... to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
    Mount Sinai Health System (12/02/24)
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  • Director , Corporate Accounts

    Mitsubishi Chemical Group (Jersey City, NJ)
    …respected - is a research-driven pharmaceutical company that has tirelessly pursued medical breakthroughs with global reach. MTPC has discovered and produced several ... treatments for difficult-to-treat diseases and commercializing products with significant unmet medical needs in North American markets. In the United States, MTPA… more
    Mitsubishi Chemical Group (11/12/24)
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  • Regional Medical Director - Full…

    FlexStaff (New York, NY)
    **Req Number** 146159 FlexStaff FlexStaff is seeking a Regional Medical Director for our client, a non-profit healthcare organization dedicated to providing home ... we encourage you to apply. Overview: As the Regional Medical Director , you will be responsible for...direct participant contact. - Must possess a Medicaid and Medicare Provider ID in good standing. *Additional Salary Detail… more
    FlexStaff (12/19/24)
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  • Lead Director , Strategic and Product…

    CVS Health (New York, NY)
    …Candidates must reside within commutable distance from a CVS or Aetna office.** The Medicare Stars and Health Equity team is seeking a Lead Dir, Health Equity & ... expanding on equity-based clinical and member experience initiatives leveraging existing Medicare product portfolio. Collaborate closely with the Medicare more
    CVS Health (01/10/25)
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  • Program Director , Pediatric Residency…

    Atlantic Health System (Morristown, NJ)
    Atlantic Health System/Goryeb Children's Hospital is Seeking a Program Director for our Pediatric Residency Training Program located in Morristown, New Jersey The ... Health System, is a branch campus of Sidney Kimmel Medical College at Thomas Jefferson University. The role of...College at Thomas Jefferson University. The role of Program Director involves a commitment of 60% administrative responsibilities and… more
    Atlantic Health System (11/06/24)
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  • Associate Director , Trade & Customer…

    Mitsubishi Chemical Group (Jersey City, NJ)
    …respected - is a research-driven pharmaceutical company that has tirelessly pursued medical breakthroughs with global reach. MTPC has discovered and produced several ... treatments for difficult-to-treat diseases and commercializing products with significant unmet medical needs in North American markets. In the United States, MTPA… more
    Mitsubishi Chemical Group (11/08/24)
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  • Senior Director Contract Performance

    Mount Sinai Health System (New York, NY)
    …is responsible for evaluating and driving performance for value-based contracts including Medicare , Medicaid and commercial arrangements. The Senior Director is ... including Powerpoint and Excel Results orientation with working knowledge of medical economics analytics Understanding of CMS programs and concepts (eg, Star… more
    Mount Sinai Health System (12/06/24)
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  • Nursing Home Admissions Director

    Morrisview Healthcare Center (Morristown, NJ)
    …Healthcare Center - MorrisView Healthcare Center is looking for an A dmission s Director to join our incredible team! We're not just a workplace; we're a community ... for a rewarding career experience, your journey begins here! Shift Hours: Admissions Director Benefits: + Competitive wages based on experience + Daily pay option… more
    Morrisview Healthcare Center (01/08/25)
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  • Director Nursing

    Elara Caring (Paterson, NJ)
    …patient care, and that is a winning combination for our leadership team. Director Nursing with Elara Caring are operationally focused and results-driven, but some of ... improving clinical outcomes and implementing QAPI programs. As a Director Nursing with us, you shape the future of...+ Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer… more
    Elara Caring (12/03/24)
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  • Web Channel and SEO Director

    CVS Health (New York, NY)
    …and affordable. **Position Summary** The Web Channel Owner role for Aetna Medicare is a critical position in our Marketing organization, with accountability for ... shepherd the delivery of Digital Marketing's capabilities backlog for Aetna.com/ Medicare , AllinaHealthAetnaMedicare.com, the Shop, Buy, and Enroll tool, and more,… more
    CVS Health (12/13/24)
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  • Regional Payer Account Director - Northeast

    Organon & Co. (Jersey City, NJ)
    **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the Executive Director , Regional Payer Accounts. The RPAD ... and programs. The primary customer/account responsibilities include key Regional Commercial and Medicare Health Plan accounts. The primary goal is to achieve desired… more
    Organon & Co. (12/21/24)
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  • Director of Healthcare Payment & Financing…

    City of New York (New York, NY)
    …position on Medicaid redesign policy and innovation. Advise and assist OSHSSA Executive Director , Chief Medical Officer and other agency executives on healthcare ... and clinicians. The Bureau of Equitable Health Services seeks to hire a Director of Healthcare Payment & Financing Initiatives. DUTIES WILL INCLUDE BUT NOT BE… more
    City of New York (12/28/24)
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  • Director , Trade and Market Access Strategy

    Mitsubishi Chemical Group (Jersey City, NJ)
    …respected - is a research-driven pharmaceutical company that has tirelessly pursued medical breakthroughs with global reach. MTPC has discovered and produced several ... for difficult-to-treat diseases and commercializing products with significant unmet medical needs in North American markets. In the United...evidence, and creating hope for all facing illness. The Director of Trade and Market Access Strategy is a… more
    Mitsubishi Chemical Group (11/19/24)
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  • Sr Director , Market Access Finance & Gross…

    Teva Pharmaceuticals (Parsippany, NJ)
    Sr Director , Market Access Finance & Gross to Net Forecasting Date: Jan 14, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals ... the Senior Vice President and US CFO, the Senior Director , Market Access Finance and Gross to Net Forecasting...contracting team to challenge, evaluate and align on Commercial, Medicare & Medicaid supplemental contracting proposals both in terms… more
    Teva Pharmaceuticals (01/15/25)
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  • Director of Patient Services, Homecare RN…

    The New Jewish Home (Bronx, NY)
    …The HAPI Division of The New Jewish Home is seeking for a full time Director of Patient Care to join our team. Job Summary: Oversees all clinical operations, ... improvement activities, training and supervision of nursing and field staff and medical compliance issues. Reports To: AVP, Home & Community Based Services and/or… more
    The New Jewish Home (12/13/24)
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  • Director , SIU / Fraud Waste and Abuse…

    Molina Healthcare (New York, NY)
    …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
    Molina Healthcare (01/13/25)
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  • Bed Board Controller, Emergency Dept Access…

    RWJBarnabas Health (Elizabeth, NJ)
    …onto Care medic system to obtain medical necessity compliance + Explains Medicare medical necessity guidelines to both physicians patients + Calls physicians ... #:0000181962 Category:Clerical / Administrative Support Status:Full-Time Shift:Night Facility:Trinitas Regional Medical Center Department:Emergency Dept Access Service Location: WILLIAMSON STREET,… more
    RWJBarnabas Health (12/31/24)
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  • Specialist, Grievance and Appeals

    VNS Health (Manhattan, NY)
    …of individual grievances and appeals. Consults with enrollees, providers and the Medical Director , as appropriate. + Provides input and recommendations for ... operations and customer service. + Reviews information available from Medicaid, Medicare , other payers, and/or professional medical organizations regarding… more
    VNS Health (10/25/24)
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