• Dental Network Service Representative

    Highmark Health (Trenton, NJ)
    …agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees. ... designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret… more
    Highmark Health (11/14/25)
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  • Pharmacy Product Director - Medicare DSNP

    Highmark Health (Trenton, NJ)
    …internal clinical and value-based evaluation committees that drive formulary and utilization management functions. + Participate in product specific Pharmacy and ... Therapeutics Committees and Drug Utilization Review (DUR) Committees as necessary or contractually required....position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (11/14/25)
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  • Senior Clinical Account Executive - Express…

    The Cigna Group (Morris Plains, NJ)
    …several health -related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, ... finance and internal teams. + Conducts clinical analysis of medication utilization and formulary performance to identify opportunities, issues, or risks. Translates… more
    The Cigna Group (11/18/25)
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  • Radiographer Per Diem Sat/Sun 7a-3p

    Atlantic Health System (Summit, NJ)
    …an Advanced Comprehensive Stroke Center. Additional Joint Commission-certified services include behavioral health care, spine surgery, wound care, and primary ... 2. Demonstrates knowledge of a variety of imaging equipment including setup, utilization , troubleshooting, and proper care and sanitization of all equipment. 3.… more
    Atlantic Health System (11/14/25)
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  • MRI Technologist, Per Diem, OMC

    Atlantic Health System (Summit, NJ)
    …an Advanced Comprehensive Stroke Center. Additional Joint Commission-certified services include behavioral health care, spine surgery, wound care, and primary ... Atlantic Health System is seeking a per diem MRI...Must demonstrate knowledge of MR imaging equipment; including set-up, utilization , basic troubleshooting and proper care for all equipment… more
    Atlantic Health System (10/20/25)
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  • LTSS Service Coordinator - Clinician

    Elevance Health (Trenton, NJ)
    …the identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... the health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will be based upon the current needs… more
    Elevance Health (09/20/25)
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  • Case Manager Registered Nurse - Field in New…

    CVS Health (Moorestown, NJ)
    At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...high-quality, cost-effective care for our members. These strategies encompass utilization management, quality improvement, network coordination, and clinical policy… more
    CVS Health (11/14/25)
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  • Nurse Navigator - Transitions of Care

    Hackensack Meridian Health (Edison, NJ)
    …for coordinating, communicating and facilitating the care of patients with Medical, Behavioral and Maternal Health needs. The navigator is accountable for ... New Jersey program and its Quality Metrics. + Knowledge of health care delivery system, utilization and review and case review procedures. + Knowledge of Social… more
    Hackensack Meridian Health (11/14/25)
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  • Sumer 2026 Analytic Enablement Graduate Intern

    Highmark Health (Trenton, NJ)
    **Company :** Highmark Health **Job Description :** **SUMMARY OF JOB RESPONSIBILITIES** We are seeking a highly motivated and skilled Graduate Intern to join the ... assessing their applicability to core healthcare payer operations (eg, utilization management, claims processing, member services). 3. Modeling & Experimentation:… more
    Highmark Health (10/28/25)
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  • Summer 2026 Quality Analytics Undergraduate Intern

    Highmark Health (Trenton, NJ)
    **Company :** Allegheny Health Network **Job Description :** Applicants must be authorized to work in the US independently. At this time, we do not offer visa ... slides and preparation for CMS TEAMS and ED CT Utilization workgroups + Exposure to VBR work, including various...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (10/08/25)
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