• Director Medicaid - Remote

    Teva Pharmaceuticals (Parsippany, NJ)
    Director Medicaid - Remote Date: Dec 27, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 58940 **Who we ... market access strategies to maximize profitability and success across Medicaid accounts. The Director will lead efforts to ensure Teva stakeholders are abreast… more
    Teva Pharmaceuticals (10/31/24)
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  • Director , IT Portfolio Management…

    Humana (Trenton, NJ)
    …part of our caring community and help us put health first** The Director , IT Portfolio Management for Enterprise Information Protection (EIP) develops and executes ... technology and innovation to improve and mature Humana's security posture. The Director develops and executes on programs defined to implement security controls,… more
    Humana (12/14/24)
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  • Director of Data Science ( Remote

    Mathematica (Trenton, NJ)
    …our benefits here: https://www.mathematica.org/career-opportunities/benefits-at-a-glance We are seeking a motivated * Director of Data Science* to lead a practice of ... some of our largest clients, including the Centers for Medicaid & Medicare Services (CMS) and other agencies. Most...lack of work. *Available Locations:* Washington, DC; Princeton, NJ; Remote #LI-AR1 # remote -usa We are an Equal… more
    Mathematica (11/21/24)
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  • Medical Director - South Central

    Humana (Trenton, NJ)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
    Humana (11/08/24)
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  • Medicare Grievances and Appeals Corporate Medical…

    Humana (Trenton, NJ)
    …of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The Corporate Medical ... Director works on problems of diverse scope and complexity...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
    Humana (01/07/25)
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  • Medical Director - Commercial Appeals

    CVS Health (Trenton, NJ)
    …for their clinical quality and effective use of health care resources. **This is a remote based (work from home) role and m** **ust have a California medical license ... Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy implementation.… more
    CVS Health (11/13/24)
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  • Director of Community Outreach Services…

    Alternatives, Inc. (Raritan, NJ)
    …illnesses. The Community Outreach Services Department is currently seeking a Director of Community Outreach Services. ESSENTIAL DUTIES AND RESPONSIBILITIES: - ... communication skills. - Familiarity or prior experience with Fee-For-Service Medicaid environments is a plus. - Experience working with...commute to the main office in Raritan NJ, and remote , using Go To Meeting. All trainings are compensated.… more
    Alternatives, Inc. (01/03/25)
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  • Director , Insurance Strategy

    Humana (Trenton, NJ)
    …is one of the largest health benefits organizations in the country. **Location:** remote The Insurance Strategy team supports Humana's Medicare and Medicaid ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
    Humana (12/21/24)
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  • Principal Client Solution Architect - State…

    Mathematica (Trenton, NJ)
    …of 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 ... and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through… more
    Mathematica (01/04/25)
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  • Senior Compliance Analyst (Interpretation…

    Prime Therapeutics (Trenton, NJ)
    …**Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior Compliance Analyst assists in the ... or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must...focus **Reporting Structure** + Reports to Sr Professional, Manager, Director or Senior Director in the Compliance… more
    Prime Therapeutics (12/17/24)
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  • Client Success Lead (Consultant) - Northwest…

    Public Consulting Group (Trenton, NJ)
    …intersection and overlap between our Special Education/Case Management and school-based Medicaid services work within a state; regularly engage with counterparts + ... clients + Understand and continually monitor Federal, state, and local Medicaid School-Based program policies and guidance, collaborating with PCG subject matter… more
    Public Consulting Group (01/01/25)
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  • Client Success Partner (Client Service Associate…

    Public Consulting Group (Trenton, NJ)
    …support the delivery of health-related services by helping schools access critical Medicaid reimbursement. Client Success Partners (CSP) are key members of the ... PCG services. This position may report to either a SBS COE Client Success Director or a Client Success Lead. **Duties and Responsibilities** _Clients_ + Own and… more
    Public Consulting Group (01/07/25)
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  • Chief Clinical Officer

    Evolent (Trenton, NJ)
    …The CCO will lead the Clinical Operations team and work with medical director leadership to ensure consistent and efficient adjudication of clinical decisions. The ... the CCO will also have dotted line oversight over field medical director (FMD) operational responsibilities, provide strategic input into medical policy and advise… more
    Evolent (12/21/24)
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