- NASCO (Trenton, NJ)
- **Overview** The Senior Corporate Counsel, Compliance & Commercial operates under general direction and is responsible for providing legal and regulatory guidance to ... and drafts complex commercial transactions, including technology agreements, and provides compliance guidance and support throughout the organization to ensure our… more
- Cardinal Health (Trenton, NJ)
- …industry best-practices. + Develops and implements compliance training to ensure compliance with federal and state regulations and laws, CMS and other ... medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles… more
- Atlantic Health System (Morristown, NJ)
- …assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and provide ongoing feedback and analysis of ... codes and professional fee services performed by providers from medical records according to ICD-10, CPT, HCPCS, and CMS...+ Audit charts for accurate and correct coding and compliance within documentation guidelines and AHS policies + Prepares… more
- Humana (Trenton, NJ)
- …community and help us put health first** The Associate Actuary, Risk and Compliance is responsible for the overall management and oversight of activities concerned ... and cost-effective approaches to minimize risks. The Associate Actuary, Risk and Compliance work assignments involve moderately complex to complex issues where the… more
- Humana (Trenton, NJ)
- …clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Evolent (Trenton, NJ)
- …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Evolent (Trenton, NJ)
- …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology… more
- Atlantic Health System (Morristown, NJ)
- …meaning we "child-size" radiation doses for pediatric patients. Our medical team features board-certified, fellowship-trained radiologists, who specialize in breast ... System has radiology services at Chilton, Hackettstown, Morristown, Newton and Overlook medical centers, along with Goryeb Children's Hospital and a variety of… more
- Evolent (Trenton, NJ)
- …Computer Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Evolent (Trenton, NJ)
- …Computer Proficiency . Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more