- Humana (Trenton, NJ)
- …segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement Professional, you ... of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual Medicare… more
- Mathematica (Princeton, NJ)
- …and/or providers. The Sr. Fellow's work could be focused on improving the Medicare , Medicare Advantage, Medicaid, and veterans and military focused programs, as ... development. This person will also lead client engagements includes serving as project director or principal investigator for one or more projects and/or serving in… more
- Virtua Health (Evesham, NJ)
- …to ensure an outstanding customer experience. Consults with Lead Physicians, Director of Practice Management, Medical Directors and staff concerning practice ... Coordinator or Supervisor required. Knowledge of insurance (ICD-9 CPT coding, Medicare regulations, state regulations, CLIA, DOH, and OSHA regulations) preferred.… more
- Cognizant (Trenton, NJ)
- …. Draft and submit the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with ... Medicare , Medicaid, and third-party guidelines. . Effectively document and...can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review… more
- Nestle (Bridgewater, NJ)
- …HME/DME customers within Nestle Health Science. This individual reports to the Director of Post Acute and will work cross-functionally to leverage our portfolio ... understanding of the HME/DME market and reimbursement processes, including Medicaid, Traditional Medicare , Medicare Advantage and value based care. * Excellent… more
- Atlantic Health System (Morristown, NJ)
- …safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in ... highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its...members. Offerings vary based on role level (Team Member, Director , Executive). Below is a general summary, with role-specific… more
- Novo Nordisk (Plainsboro, NJ)
- …Are you ready to maximize your potential with us? The Position Assist Director of Institutional Contracts in managing the development and implementation of 340B as ... Inflation Reduction Act ("IRA") processes and compliance activities for the Medicare Drug Negotiation Program. Ensures accurate and timely input and implementation… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …Managed Care Rebates leads department staff in the processing of Managed Care, Medicare Part D, Managed Medicaid, CMS Rebates, and Medical Rebate claims and fees ... The Senior Manager, Managed Care Rebates reports to the Director of Brand and Generic Rebates. **Essential Functions** *...exceptions * Assist in providing operational direction to the Director of Rebates and internal teams on identification of… more
- Cardinal Health (Trenton, NJ)
- …and compliance issues. **Compliance Audit Manager** Reporting to the Compliance Director , this position supervises and manages compliance audits to determine ... services and/or hospital (technical) services. This position will also support the Director with transactional audit diligence and integration planning, as well as… more
- Cordis (NJ)
- …Business) through direct case support. Reports to National Clinical Sales Director . **Responsibilities** + Responsible for meeting revenue generation targets on ... Track sales and support activities as needed and directed by the National Director in coordination with additional sales support. + Completes training and manages… more