- BriteLife Recovery (Englewood, NJ)
- …SUD programs. + Knowledge of major insurance provider platforms (eg, Optum, Aetna , BCBS, Cigna). + Strong clinical writing skills and familiarity with medical ... necessity language. + Ability to advocate for clients while balancing payer relationships and compliance. + Ability to lift up to 25 pounds. + Ability to walk up and down stairs during emergency drills or situations. All ARS subsidiaries are committed to… more
- CVS Health (Trenton, NJ)
- …standards, normative comparisons with industry peers, best practice research and Aetna specific business and technology requirements. Helping define, drive and ... deliver all aspects of the data science product lifecycle, from requirements gathering, education, and strategy, to study design, solution architecting, programming, testing, implementation, delivery, and iteration of data science analytics products.… more
- ProSmile (Plainfield, NJ)
- …(30-35 hours per week): + Medical Insurance: Choice of five comprehensive Aetna medical plans, including options with low copays, deductible-sharing, and national ... provider networks. + Dental Insurance: MetLife plans offering preventative, basic, major, and orthodontic coverage options. + Vision Insurance: Davis and UHC vision plans with annual exams, eyewear allowances, and contact lens benefits. + Flexible Spending &… more
- CVS Health (Ocean, NJ)
- …every day. **Position Summary** This Case Manager Registered Nurse position is with Aetna 's Integrated Care Management (ICM) team and is a field-based position out ... of the Northern and Central Regions of NJ. The requirements is for candidates to hold a New Jersey Registered Nurse License, and to travel 50-75% of the time to meet with members face to face. The care manager is responsible for assessing and evaluating… more
- ProSmile (Plainfield, NJ)
- …(30-35 hours per week): + Medical Insurance: Choice of five comprehensive Aetna medical plans, including options with low copays, deductible-sharing, and national ... provider networks. + Dental Insurance: MetLife plans offering preventative, basic, major, and orthodontic coverage options. + Vision Insurance: Davis and UHC vision plans with annual exams, eyewear allowances, and contact lens benefits. + Flexible Spending &… more
- CVS Health (Trenton, NJ)
- …8:00am - 11:30am EST.** American Health Holding, Inc. (AHH), a division of Aetna /CVS Health, is a URAC-accredited medical management organization founded in 1993. We ... provide flexible, cost-effective care management solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key Responsibilities** + Apply critical thinking and… more
- CVS Health (Trenton, NJ)
- …**Underwriting role is for Meritain Health** , an independent subsidiary of Aetna and CVS, and one of the nation's largest employee benefits administrators. ... We have the resources of a national carrier coupled with the unique flexibility and devoted service of a third-party administrator (TPA). The Meritain Health underwriting department supports the attainment of organizational goals through the issuance of… more
- CVS Health (Trenton, NJ)
- …Health Partner Innovation Strategy will report to strategy & product within Aetna 's Mental Well-being organization. They will be responsible for coordinating across ... various functional partners to support the strategy and execution of new and existing strategic partnerships. This includes supporting the development of partnership strategy and evaluation of new partnership opportunities to align with strategic initiatives.… more
- CVS Health (Trenton, NJ)
- …Health within the Business Analysis Team. We are an independent subsidiary of Aetna and CVS, and one of the nation's largest employee benefits administrators. We ... have the resources of a national carrier coupled with the unique flexibility and devoted service of a third-party administrator (TPA). The Meritain Health Business Analysis Team supports the attainment of organizational goals through the issuance of… more
- CVS Health (Trenton, NJ)
- …"fix" tickets to either the First Health load team or to payors, such as Aetna . + Work with internal teams and attend meetings to review status and questions ... regarding repricing projects or system data. + First Health system review to determine network data accuracy and par vs non-par status of providers. + Help internal and external customers with correct processes for escalations, questions, fixes, and general… more