- Evolent (Trenton, NJ)
- …compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation ... under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person"… more
- Evolent (Trenton, NJ)
- …compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation ... under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person"… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and ... to an organization focused on continuously improving consumer experiences + 3+ years health industry experience with ASA, or 1+ years health industry experience… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall ... health outcomes with a focus on prescription drugs. The...Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years… more
- CenterWell (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Care Delivery Call Quality Professional works within the PCO Growth and Retention group. ... and monitoring the Tele Sales Agents who are responsible for converting Medicare eligible callers to patients. The Care Delivery Call Quality Professional is… more
- Cognizant (Trenton, NJ)
- …Necessity Reviews can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review ... denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing… more
- Novo Nordisk (Plainsboro, NJ)
- …forecast gross to net components including but not limited to Managed Care, and Medicare Part D, Medicaid as well as current and future Healthcare Reform related ... in forecasting of key rebate categories included but not limited to Commercial, Medicare Part D, Coverage Gap, and Medicaid + Demonstrated analytical skills via MS… more
- Ascendis Pharma (Princeton, NJ)
- …+ Various incentive compensation plans + Accident, Critical Illness, and Hospital Indemnity Insurance + Mental Health resources + Paid leave benefits for new ... administration of rebate programs, including government rebates (eg, Medicaid, Medicare ), managed care rebates, and commercial rebates. Ensure accurate calculation,… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... BSN or Bachelor's degree in a related field + Health Plan experience + Experience in utilization management or...criteria to ensure appropriateness of care preferred + Previous Medicare experience a plus + Milliman MCG experience preferred… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Technology Solution Implementation Professional delivers new technological solutions to ... Operations in electronic transmissions set-up for state regulatory partners, health information exchanges, and vendor partners. **Responsibilities:** Works with ETL… more