- Molina Healthcare (New York, NY)
- …the benefits, operations, communication, reporting, and data exchange of the Medicare /MMP product in support of strategic and corporate business objectives. Manage ... for all Medicare lines of business the annual Medicare ...including adhoc projects and submissions as assigned by the Manager of Mandated Materials or designee. **KNOWLEDGE/SKILLS/ABILITIES** + Experience… more
- Terumo Medical Corporation (Somerset, NJ)
- …State transparency reporting obligations, and measuring the effectiveness of the compliance program . The Senior Compliance Manager -Monitoring & Transparency ... Sr . Compliance Manager - Monitoring &...senior management to create efficiencies in the compliance program and track its effectiveness. Develops insightful dashboards and… more
- Cardinal Health (Trenton, NJ)
- …therapies to patients who need them-faster.** **_Responsibilities_** The Case Manager supports patient access to therapy through Reimbursement Support Services ... in accordance with the program business rules and HIPAA regulations. This position is...investigations, prior authorizations, and appeals, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and… more
- Elevance Health (Woodbridge, NJ)
- …the Possibilities. Make an Extraordinary Impact.** **Title** : Pharmacist Clinical Sr . **Location(s):** Candidates must reside within 50 miles or 1-hour commute ... each way of an Elevance Health office (PulsePoint). The **Pharmacist Clinical Sr .** is responsible for developing and implementing pharmacy programs. **How you will… more
- CVS Health (Trenton, NJ)
- …with provider engagement, relations, or account management. + Working knowledge of Medicare contracts. + An understanding of value based contracts, how they work, ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...includes an award target in the company's equity award program . In addition to your compensation, enjoy the rewards… more
- CVS Health (Trenton, NJ)
- …more compassionate. And we do it all with heart, each and every day. This Senior Manager , Regulatory Affairs position is a crucial contributor to the Medicare ... PBM business. This position reports directly to the Director of Medicare Regulatory Affairs. **Duties and Responsibilities:** *Abiity to provide comprehensive market… more
- CVS Health (Trenton, NJ)
- …in new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products ... Medicare plans within the Market. + Direction of senior leaders of specific functional areas as assigned. Functional...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Trenton, NJ)
- …we do it all with heart, each and every day. **Position Summary** The Senior Manager , Strategic Marketing is responsible for supporting primarily the Medicare ... oversee. Using the National strategy as the basis, the Senior Manager , Strategic Marketing will work in...close collaboration with their local market partners, the greater Medicare marketing team, and sales business partners to drive… more
- Highmark Health (Trenton, NJ)
- …delivery of data to vendors and internal partners, supporting successful Medicare Advantage and Dual-Special Needs Plan member satisfaction strategies, including ... Medicare CAHPS and the Health Outcomes Survey. Additional responsibilities...Work with business and technical organizations to drive out program strategy and approach. Organize, plan, and maintain … more
- Cardinal Health (Trenton, NJ)
- …can get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through ... patient support services in accordance with the program business rules and HIPAA regulations. This role involves care coordination, insurance verification and… more
- 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
- 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
- CVS Health (Trenton, NJ)
- …supporting provider data and inventory management. + Familiarity working in Medicaid, Medicare and Commercial lines of business. + Strong project management skills + ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...includes an award target in the company's equity award program . In addition to your compensation, enjoy the rewards… more
- Elevance Health (Woodbridge, NJ)
- …member-centered, lasting pharmacy care. The ** Senior Test Lead (Business Change Manager Senior )** will be responsible for working with management to identify ... ** Senior Test Lead - Pharmacy Benefit Manager...you will make an impact:** + Manage relationships with project/ program stakeholders (IT and business). + Develop and implement… more
- CenterWell (Trenton, NJ)
- …part of our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health ... outcomes with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the… more
- VNS Health (Manhattan, NY)
- …CFEEC scheduled dates and outcomes as needed. * Offers assignment of Medicare assistance as needed. * Responds to inquiries regarding pre-enrollment issues, ... eligibility and program information to ensure service satisfaction. Works with our...for new enrollees start of care authorizations and care manager assignment. * Assists in the monitoring and updating… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Manager , Technology Leadership is responsible for all aspects of software or hardware product ... delivery and performance. The Manager , Technology Leadership works within specific guidelines and procedures;...supports one clinical platform for three Medicaid and two Medicare plans; integration between Clinical and 4+ other systems… more
- Gentiva (Hamilton, NJ)
- …Reimbursement** You will report directly to the Executive Director, Administrator, or Senior Patient Care Manager . You will be responsible for maintaining ... every day. **Overview** We're looking for a **Patient Care Manager ** to join our team. **RN Clinical Manager...Time Employee Benefits:** + **Medical, Dental, Vision** + **Wellness Program and Resources** + **401k match** + **PTO** +… more
- Molina Healthcare (New York, NY)
- …the severity of illness and the site of service. This position will support our Senior Whole Health business. Senior Whole Health by Molina is a Managed ... or disabled people who are eligible for Medicaid and Medicare . We are looking for Case Managers with a...Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or master's degree in a social… more
- Molina Healthcare (New York, NY)
- **Job Description** **Job Summary** The Provider Engagement Manager implements Health Plan provider engagement strategy to achieve positive quality and risk ... meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using… more