- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Associate Director, HEDIS Operations of Non-Standard Supplemental for business operations ... of, numerous strategies required to ensure success for our Medicare Stars and Medicaid LOBs. The ideal candidate for...data to identify trends and opportunities for improved member health and measure compliance + Internal and external partnerships… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Humana Integrated Business Advancement (IBA) - BI (Business Intelligence) team is a high ... Intelligence Engineer position will be supporting BI work for our Medicare organizations. **Senior Business Intelligence Engineer** : + Develops and maintains… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Lead, Data Quality/Integrity understands end-to-end master data processes and flows and ... reporting on progress, challenges, and achievements to management. + Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Actuarial Analyst 1 provides actuarial support across a broad range of actuarial and ... + SAS and/or Databricks experience + Programming experience in SQL and VBA + Medicare Part D knowledge Travel: While this is a remote position, occasional travel to… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Actuary, Pricing is responsible for setting pricing assumptions, submitting bids, filing ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage experience + Strong Communication Skills + Ability to… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated ... Coder + Demonstrate ability to problem-solve complex coding issues + Experience with Medicare and Medicaid coding guidelines + Strong data entry and attention to… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** This Actuarial Analyst 2 position is a part of the HealthCare Economics team focused on ... 2+ years of actuarial experience in healthcare + SAS or other coding skills + Medicare experience + Familiarity with CMS Star Ratings Travel: While this is a remote… more
- Sedgwick (Trenton, NJ)
- …limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health savings account, and ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | General Liability BI | Captive...Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier;… more
- Bristol Myers Squibb (Princeton, NJ)
- …401(K). Financial protection benefits such as short- and long-term disability, life insurance , supplemental health insurance , business travel protection and ... and deep experience with commercial payers, payer contracting, and health economics + Deep understanding of Medicare ...and health economics + Deep understanding of Medicare and Medicaid policies related to CAR T therapies… more
- United Methodist Communities (Ocean City, NJ)
- …items & additional uniform allowances + Additional great benefits like Vision coverage, Health Savings Account, Voluntary Life Insurance & so much more! UMC ... to assure it accurately reflects resident status and maximize reimbursements for Medicare A residents. Monitors the overall process and tracking of RAI/MDS… more