- Highmark Health (Trenton, NJ)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... experience in managed care pharmacy + 2 years of clinical account management experience in Medicare as part of the 4 year managed care experience + 2 years of… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app ... annual pricing of Humana's largest segment of business, individual plan Medicare Advantage. The team consists of actuaries and business technology professionals… more
- Centene Corporation (Trenton, NJ)
- …per year Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid ... Centene is transforming the health of our communities one person at a...Responsible for the growth and performance of the assigned Medicare region to meet membership, pre-tax earnings, quality, network… more
- Humana (Trenton, NJ)
- …experiences **Preferred Qualifications** + Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, ... part of our caring community and help us put health first** The Corporate Medical Director relies on medical...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- Humana (Trenton, NJ)
- …review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or ... products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , or other healthcare providers. + Utilization… more
- Zelis (NJ)
- …and financial negotiation with providers + Experience and working knowledge of Health Insurance , Medicare guidelines and various healthcare programs ... match, flexible paid time off, holidays, parental leaves, life and disability insurance , and health benefits including medical, dental, vision, and prescription… more
- Humana (Trenton, NJ)
- …review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or ... or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice… more
- Merck (Trenton, NJ)
- …sales or operations, project management, or reimbursement support * Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) ... how the products are covered under the benefit design (Commercial, Medicare , Medicaid) * Answer questions about coverage, including payer-specific access questions… more
- Humana (Trenton, NJ)
- …organization focused on continuously improving consumer experiences **Preferred Qualifications** + Health insurance experience + Medicare Advantage ... **Become a part of our caring community and help us put health first** The Actuarial Analyst 2, Pricing is responsible for setting pricing assumptions, submitting… more
- Merck (Trenton, NJ)
- …sales or operations, project management, or reimbursement support * Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) ... Available benefits include medical, dental, vision healthcare and other insurance benefits (for employee and family), retirement benefits, including 401(k),… more