• Sr. Manager, Medicaid Contract…

    Sumitomo Pharma (Trenton, NJ)
    …highly motivated, and experienced individual for the position of Sr. Manager, Medicaid Contract Administration. This position is responsible for managing the ... Medicaid rebate team in receiving, processing, validating, trouble-shooting ...in processing data submitted by customers and proactively advises management of issues. + Able to identify and recommend… more
    Sumitomo Pharma (07/09/25)
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  • Business Analyst, Medicaid Intake Business…

    CVS Health (Trenton, NJ)
    …we do it all with heart, each and every day. **Position Summary** The Medicaid Intake Business Operations team seeks an analyst with expertise in electronic claim ... This team ensures the quality and integrity of Intake processes for all Medicaid incoming claim transactions. In this position, you will provide initial support for… more
    CVS Health (07/27/25)
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  • Care Management Support Assistant

    Humana (Trenton, NJ)
    …the Applied Behavioral Analysis Program, and Expanded Benefits Outreach The Care Management Support Assistant Intern will utilize Humana's Medicaid training and ... first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are… more
    Humana (07/25/25)
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  • Medication Therapy Management (MTM)…

    Prime Therapeutics (Trenton, NJ)
    …and drives every decision we make. **Job Posting Title** Medication Therapy Management (MTM) Technician **Job Description** The MTM Technician is responsible for ... of business to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality measure programs,...measure programs, including but not limited to: Medication Therapy Management (MTM), Adherence, and Statin use in Persons with… more
    Prime Therapeutics (07/16/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Trenton, NJ)
    …external constituents in the coordination and administration of the utilization/benefit management function. Required Qualifications + Registered Nurse in state of ... of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
    CVS Health (07/26/25)
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  • Senior Manager, Network Management…

    CVS Health (Trenton, NJ)
    …next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager. In this role, you will manage negotiations, conduct high-level ... initiatives and settlement activities. * Assist with the design, development, management , and or implementation of strategic network configurations and integration… more
    CVS Health (07/19/25)
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  • Pricing & Contracts Sr. Analyst

    embecta (Parsippany, NJ)
    …America commercial teams, including Strategic Accounts (Managed Care and Retail), Channel Management , GPO, Long-term Care, Acute Care, PBM, Mail order and DME ... America commercial contracting; to include drafting, amending, redlining, warehousing, management , and coordination with embecta counsel and other internal… more
    embecta (07/26/25)
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  • Pharmacist - Clinical Advisor

    CVS Health (Trenton, NJ)
    …or within a health plan. + Experience in all market segments (Medicare, Medicaid , Exchange andCommercial) + Expertise in Utilization Management , Formulary ... least 2 and up to 4 market segments for any particular client (Medicare, Medicaid , Exchange, and or Commercial). The Health Plan Clinical Advisor is responsible for… more
    CVS Health (07/29/25)
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  • Full Time Patient Access Associate - Outpatient…

    Penn Medicine (Plainsboro, NJ)
    …Infusion. 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. + Prints...Media Manager. + Processes correspondence from insurance carriers, case management and other areas within one business day of… more
    Penn Medicine (07/30/25)
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  • Counsel - Corporate Contracts and Regulatory…

    Atlantic Health System (Morristown, NJ)
    …with Contract Coordinators, oversee physician, real estate and contract management process, including development of electronic databases. Assume primary ... mergers, acquisitions, affiliations and joint ventures, serving as a resource for the management of the due diligence process. -Serve as a key subject matter… more
    Atlantic Health System (07/21/25)
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