- Prime Therapeutics (Trenton, NJ)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Claims Operations Business Analyst - Remote **Job Description ... Summary** Serves as liaison between departmental team business owners, end users, IT, Claims and...Medicare, requires 3+ years of experience working in Medicare Operations . **Work Experience** Work Experience - Required: Business… more
- Humana (Trenton, NJ)
- …caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy ... of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional...**Responsibilities** The Senior Pharmacy Claims Operations Professional analyzes, monitors and enhances business … more
- HealthEdge Software Inc (Trenton, NJ)
- …integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration ... **Overview** ** Senior Manager, Product Operation** **Position Overview:** We areseekinga...our product teams to solve hard problems-customer problems and business problems-in ways that our customers love and that… more
- MetLife (Bridgewater, NJ)
- …a month for office meetings Key Responsibilities: * Conduct quality reviews of LTD claims of various complexity * Identify trends, root causes and quality gaps from ... and management regarding performance and quality standards * Partners with team and claims organization to develop criteria and standards in which to measure quality… more
- Zurich NA (Trenton, NJ)
- Senior US International Reverse Flow Underwriter 117849 Zurich is seeking a senior level US International Reverse Flow Underwriter to join our International ... Operations team in our Schaumburg, IL North America Headquarters....provide US underwriting support for incoming received country (RC) business from non-US producing countries. In this model the… more
- Evolent Health (Trenton, NJ)
- …products. You will collaborate with cross-functional teams, including solution strategy, business operations , engineering, quality assurance, and IT, to ensure ... You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst, you will have the opportunity to...market, and the customers. They collaborate with implementation teams, business operations , engineering, and growth teams to… more
- Prime Therapeutics (Trenton, NJ)
- …across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance ... guidance and regulatory issues that impact Prime's compliance programs or business operations ; document requirements or disciplinary actions and escalate… more
- Dr. Reddy's Laboratories (Princeton, NJ)
- …+ You will be responsible for providing legal advice to the commercial business and operations , supporting approved and pipeline products, primarily in the ... our Global Legal and Compliance ("GLC") Team, as a Senior Legal Counsel - Commercial. This role will support...a 'brand attorney' who will advise commercial businesses and operations regarding approved and pipeline products, including working with… more
- Fujifilm (Trenton, NJ)
- …please visit_ _healthcaresolutions-us.fujifilm.com_ _._ **External US** **Job Title:** ** Senior Compliance Specialist** **Job purpose** The accomplished Senior ... Compliance Specialist will support FUJIFILM's Corporate compliance program operations to ensure high ethical standards are observed and compliance program is… more
- Prime Therapeutics (Trenton, NJ)
- …file maintenance of enrollment, assessment and dis-enrollment documentation for strategic business unit (SBU) operations . **Job Description** + Effectively ... and drives every decision we make. **Job Posting Title** Senior Enrollment Specialist **Job Description Summary** This position is...supports Magellan's SBU program operations ensuring that data is entered accurately and timely… more
- Cardinal Health (Trenton, NJ)
- …colleagues as a coveted member of the Product Experience organization. As a Senior Product Experience Designer, you will define, lead, and implement the analytics ... their practices' financial performance. These products help monitor drug utilization, claims payment and denials, reimbursement trends, margins, and provide insights… more
- Cardinal Health (Trenton, NJ)
- …of data to create innovative solutions that improve patient outcomes, streamline operations , and enhance the overall healthcare experience. We are seeking a highly ... Difference: Contribute to cutting-edge solutions that improve patient care, enhance healthcare operations , and drive positive change in the industry. + Work with a… more
- CVS Health (Trenton, NJ)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Ascendis Pharma (Princeton, NJ)
- …trends, and rebate liabilities. Generate regular reports and presentations for senior management, providing insights into contracting operations and financial ... skills. Ascendis Pharma is looking to hire an experienced Director, Contract Operations to join our team. Responsibilities will include implementing market access… more
- Conviva (Trenton, NJ)
- …and help us put health first** The Revenue Cycle Manager (Onshore Operations ) oversees the onshore team responsible for the comprehensive management of revenue ... Professional and Payment Posting Auditors who work to ensure accurate financial operations and proper payment posting. The manager is also responsible for process… more
- Daiichi Sankyo Inc. (Basking Ridge, NJ)
- …solutions as a brand attorney and the primary legal advisor for the commercial business and operations supporting US approved (or to be approved) oncology ... brand attorney and lead legal advisor for the commercial business and operations supporting US approved (or...current developments in several key legal areas and provides Senior Management and other business leaders with… more
- Humana (Trenton, NJ)
- …remote In this lead role you'll have the opportunity to analyze complex business and clinical issues leveraging healthcare and operational data to support healthcare ... collaboratively with clinicians, data scientists, actuaries, subject matter experts, and business owners across Humana to drive solutions forward. In this role… more
- Humana (Trenton, NJ)
- …to evaluate claims data to drive deeper insights into the business and identify opportunities + Coordinate Value-Based impacts across Humana and CenterWell ... Experience in managing data to support and influence decisions on day-to-day operations , strategic planning, and specific business performance issues. + Advanced… more
- IGT (Trenton, NJ)
- …of NSNJ and provide services that help NSNJ support the New Jersey Lottery's operations . Most recently, NSNJ helped the New Jersey Lottery set a new annual sales ... program. **Overview** The Product Manager - Draw Games will work directly with the Senior Director of Marketing to ensure flawless execution of all Draw Game plans… more
- Sanofi Group (Bridgewater, NJ)
- …we aim at growing our US business by $ 1 billion. A Business and Technology Modernization department within Commercial Operations was recently created with ... fast, and we're always looking for talented professionals to join our Commercial Operations ' team. We are an innovative global healthcare company that helps the… more