- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Trenton, NJ)
- …part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Trenton, NJ)
- …part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). ... The Medical director work assignments involve moderately complex to complex issues... will collaborate with clinicians and support staff to provide Humana members with optimal value-based care in accordance… more
- 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 (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 reviewing of all submitted medical records, synthesizing complex… more
- Organon & Co. (Jersey City, NJ)
- **Job Description** **The** **Position** The Director , Clinical Pharmacology Lead will be responsible for contributing and/or devising the clinical pharmacology ... The Clinical Pharmacology Lead will serve as the medical monitor and/or study director responsible for the execution (in conjunction with the TMED Operations Lead)… more
- Rowan College at Burlington County (Mount Laurel, NJ)
- Director of Nursing Program (Associates Degree) Print (https://www.schooljobs.com/careers/rcbcedu/jobs/newprint/5011138) Apply Director of Nursing Program ... 07/17/2025 + Description + Benefits + Questions Description SUMMARY DESCRIPTION:The Director position is responsible for the management, coordination, and evaluation… more
- Sedgwick (Trenton, NJ)
- …Medical Director and vendor partner(s) on physician identification and credentialing processes, MCO provider additions and removals, MCO network issues; ... regulations regarding MCO services; and to work with MCO provider on physician credentialing , MCO additions and...to work with MCO provider on physician credentialing , MCO additions and removals, network and problematic issues.… more