- CVS Health (NJ)
- …2 and up to 4 market segments for any particular client (Medicare, Medicaid , Exchange, or Commercial). The Health Plan Clinical Advisor is responsible for ... within a health plan. + Experience in all market segments (Medicare, Medicaid , Exchange and Commercial) + Expertise in Utilization Management, Formulary Management… more
- CVS Health (NJ)
- …each and every day. **Position Summary** The Sr. Business Analyst supports Medicaid Enrollment Operations by making data accessible and actionable for teams and ... report on vendor performance data. + Familiarity with Medicare and Medicaid regulations. **Education** + Associates degree or equivalent experience. **Anticipated… more
- Cognizant (Trenton, NJ)
- …diploma or GED required. Experience: Minium of two-three years of Medicaid and or Commercial claims **_payer_** processing experience. Technical Competencies: + ... and standard of billing guidelines required. + FACETS experience (highly preferred) + Medicaid knowledge (required) + Keyboard skills of at least 35 WPM + 10-key… more
- Elevance Health (Morristown, NJ)
- …performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of business. **How You Will Make an ... limited to: + Analyzes and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives. + Performs data mining and… more
- RWJBarnabas Health (New Brunswick, NJ)
- …of Medicaid and other financial assistance application and initiates eligibility determination for Health System's charity care fund. Job Requirements: + HS ... requires quick turnaround and quality output Preferred: + Prior experience with Medicaid and Charity Care Scheduling Requirements: + Full-time + Rotating Schedule:… more
- Penn Medicine (Plainsboro, NJ)
- …X-rays. Validation includes but is not limited to verifying eligibility , obtaining benefits, ensuring pre-certification and/or authorization /referral requirements ... to have been completed. Refers patient to Medicaid Screener or Financial Counselor as needed. + Demonstrates...to Financial Counselor for assistance and/or refers patients for Medicaid Assistance. Ensures ABN is reviewed with patients, and… more
- Atlantic Health System (Morristown, NJ)
- …- its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in 2020. Morristown ... twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start...as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and… more
- Ascendis Pharma (Princeton, NJ)
- …Oversee the administration of rebate programs, including government rebates (eg, Medicaid , Medicare), managed care rebates, and commercial rebates. Ensure accurate ... contracting strategies across various payer segments (eg, commercial, Medicare, Medicaid ). + Excellent negotiation, communication, and interpersonal skills, with the… more
- RWJBarnabas Health (Lakewood, NJ)
- …of Medicaid and other financial assistance application and initiates eligibility determination for Health System's charity care fund. Essential Functions: + Take ... requires quick turnaround and quality output Preferred: + Prior experience with Medicaid and Charity Care Scheduling Requirements: + Full-time, Evenings + 3pm-11pm… more
- Atlantic Health System (Morristown, NJ)
- …fraud and abuse issues, HIPAA compliance, EMTALA, Medicare and Medicaid compliance, licensure issues, pay-to-play issues, corporate governance and regulatory ... corporate work experience, including prior experience with hospitals, Medicare and Medicaid , and federal and state healthcare regulatory issues, including fraud and… more
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