- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Dec 4, 2025 Location: Parsippany, United States, 07054 Company: Teva Pharmaceuticals Job Id: 64915 **Who we are** Together, we're on a ... people to make a difference with. **The opportunity** The Medicaid Claims Analyst is responsible for Medicaid ...The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes validating, verifying, disputing… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence ... Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing … more
- Humana (Trenton, NJ)
- …and other reference sources. Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and will understand how to ... an inpatient and/or outpatient environment and/or related to care of a Medicaid population (TANF and expansion populations). + Current and ongoing Board… more
- Prime Therapeutics (Trenton, NJ)
- …we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government Programs - Medicare & ... Managed Medicaid is responsible for the development, administration, and execution...+ Provide leadership and oversight to the Medicare and Medicaid teams and ensure the development and execution of… more
- Humana (Trenton, NJ)
- …Senior Market Finance Professional supports more than half of Humana's Medicaid business, providing technical financial analysis and data-driven insights to drive ... with Market CFOs, clinical teams, and provider engagement teams, focusing on Medicaid claims and premium analytics across multiple states, including established and… more
- CVS Health (Trenton, NJ)
- …it all with heart, each and every day. **Position Summary** + The Medicaid VBS Network State Manager manages and oversees compliance with our Network ... responsibilities as provided within the State Medicaid contractual requirements as outlined below: + Accountable for...to meet total cost and quality goals for our Medicaid businesses. + Responsible for deploying alternative payment models,… more
- Deloitte (Jersey City, NJ)
- …services to public sector clients + Support engagements focused on Medicaid reimbursement, including actuarial rate development across managed care and ... fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...plan/insurance company experience + 2+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate… more
- Humana (Trenton, NJ)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Cognizant (Trenton, NJ)
- **About the role** **Schedule:** M-F **Traveling Required:** 40% As a Medicaid Eligibility Delivery Director, you will make an impact by overseeing access, ... experience. + Minimum of ten (10) years of experience in state Medicaid and Medicare eligibility, enrollment operations, health plan administration, or regulatory… more
- Humana (Trenton, NJ)
- …caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness ... in identification of cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. The Actuary, Analytics/Forecasting ensures data integrity by… more