- CVS Health (Trenton, NJ)
- …support segment leaders with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. **You will make an impact by:** . Supporting the process ... for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners. . Developing relationships with leaders of specialty chronic… more
- Humana (Trenton, NJ)
- …of the appropriate courses of action. **Role Description:** Support Medicaid Implementations and Operations in electronic transmissions set-up for state ... while minimizing disruption and mitigating risks + Experience with Medicare and/or Medicaid + Ability to coordinate with development and user teams to assess… 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
- Ascendis Pharma (Princeton, NJ)
- …of monthly, quarterly, and annual GP reports to CMS, VA/DoD, and state Medicaid agencies, and any programs requiring price reporting, per legislative requirements + ... programs + Deep expertise in US Federal and State Pricing Programs ( Medicaid , Medicare, VA/DoD, PHS/340B) and related regulations. + Expertise in GP reporting… more
- Pillar Care Continuum (East Hanover, NJ)
- …and community inclusion, in accordance with DDD policies and Medicaid waiver requirements. + Establishes and implements standardized systems across ... programs. + Strong working knowledge of New Jersey DDD, OOL, and Medicaid -funded service models. + Proven ability to manage large teams, oversee multiple… more
- CVS Health (Trenton, NJ)
- …submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... (ICD) codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred.… more
- Humana (Trenton, NJ)
- …+ Support the development of multi-channel campaign strategies across Medicare, Medicaid , and Commercial lines of business + Translate business objectives and ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Intermountain Health (Trenton, NJ)
- …payer re-credentialing requests and demographic/roster requests. + Completes out-of-State Medicaid individual and facility enrollments timely and accurately for ... all aspects of provider enrollment with commercial and government (Medicare and Medicaid ) professional fee payer contracts for an entire market. Ensures enrollment… more
- Option Care Health (Trenton, NJ)
- …offices and hospitals (Commercial Insurance, Medicare Part B & D, Fee for Service Medicaid , Managed Medicaid ) Due to state pay transparency laws, the full range ... for the position is below: Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data. Pay Range is $160,107.21-$266,852.84 **Benefits:** -Medical, Dental, &… more
- Humana (Trenton, NJ)
- …Home, and Quality Recognition programs across multiple lines of business (Medicare and Medicaid ). + Utilizes complex SQL, SAS, and other technical skills to drive ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more