- Oracle (Trenton, NJ)
- …applications and dashboards that run in our clients EHR (Electronic Health Record) system to enable our clients' to track compliance with the requirements of the ... Centers for Medicare & Medicaid Services ( CMS ) and The Joint Commission (TJC). The compliance rate...you to work closely with multi-functional teams, including product management , submissions operations teams, and other software development teams… more
- Highmark Health (Trenton, NJ)
- …clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services ( CMS ) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. ... Patient Monitoring (RPM) risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses… more
- Educational Testing Service (Princeton, NJ)
- …+ Oversee end-to-end configuration and optimization within the e-commerce CMS , preferably Salesforce Commerce Cloud, partnering with engineering and merchandising ... and guiding products from concept through launch. + Familiarity with APIs, system integrations, and modern data architectures. + Ability to balance strategic… more
- Humana (Trenton, NJ)
- …and work is assisted by diverse resources, included but not limited to CMS policies, National and Local Coverage Determinations, CMS -recognized Compendia, NCCN, ... participation in hearings involving an Administrative Law Judge, support for CMS audits, cross-functional team activities, and other responsibilities as determined… more
- Humana (Trenton, NJ)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual ... by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts.… more
- Atlantic Health System (Morristown, NJ)
- …enterprises. This role ensures enterprise-wide compliance with the Joint Commission, CMS , NCQA, and applicable state and federal regulations, while optimizing ... provider accountability, and operational excellence. Position Summary: + Provide system -level strategic leadership for all credentialing and privileging operations,… more
- Humana (Trenton, NJ)
- …by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from inpatient or post-acute care… more
- Ascendis Pharma (Princeton, NJ)
- …340B/PHS, FSS/VA, ASP, NFAMP, FCP, IFF, and URA. + Oversee the management of GP models, including calculation, validation, documentation, and submission of monthly, ... quarterly, and annual GP reports to CMS , VA/DoD, and state Medicaid agencies, and any programs...related analytics and reporting. + Prior experience interfacing with CMS , VA, and/or external auditors. + Experience with product… more
- Bristol Myers Squibb (Princeton, NJ)
- … teams, and Business Insights & Technology to ensure taxonomy alignment with system metadata, identity management , and analytics outputs. The role drives ... enable personalization, automation, asset discovery, measurement, and velocity across content , sales, and technical workflows. The Associate Director manages tagging… more
- Atlantic Health System (Morristown, NJ)
- …and accurate code assignments in accordance with Center of Medicare and Medicaid ( CMS ) guidelines and provide ongoing feedback and analysis of the education needs ... from medical records according to ICD-10, CPT, HCPCS, and CMS guidelines + Responsible for maintaining up to date...and Coding and billing experience #LI-AW1 At Atlantic Health System , our promise to our communities is; Anyone who… more
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