• Program Lead - Physical Therapist (PT)

    Genesis Healthcare (Belmar, NJ)
    …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... support Visa or Green Card sponsorships, plus our Journey Travel Program lets you work across the US with...rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization ,… more
    Genesis Healthcare (07/04/25)
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  • Strategic Client Executive - TPA

    Zelis (NJ)
    …electronic payments and/or healthcare communications solutions. + Demonstrated success in revenue management and increased utilization within an assigned book of ... electronic payments and/or healthcare communications solutions. + Demonstrated success in revenue management and increased utilization within an assigned book of… more
    Zelis (07/23/25)
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  • Medical Director - Florida

    Humana (Trenton, NJ)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/29/25)
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  • Medical Director - South Carolina SE Region

    Humana (Trenton, NJ)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/22/25)
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  • Medical Director - Mid West Region

    Humana (Trenton, NJ)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (05/14/25)
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  • Medical Director - NorthEast Region

    Humana (Trenton, NJ)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/25/25)
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  • Care Manager RN - (Remote)

    Highmark Health (Trenton, NJ)
    …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... , identification of opportunities for referral to a Health Coach/ case management , and identification and resolution of...clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS**… more
    Highmark Health (07/12/25)
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  • Medical Director, Clinical Services

    Highmark Health (Trenton, NJ)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
    Highmark Health (07/29/25)
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  • Vice President, Strategic Accounts

    Datavant (Trenton, NJ)
    …benchmarking, goal setting, timely execution, and superior leadership. + Strong utilization of SalesForce to include monitoring and documenting member information. + ... Understanding and utilization of P&Ls to assist in reducing cost while...book of business. Qualifications: + Minimum of 5 years management or sales experience in a healthcare environment +… more
    Datavant (07/03/25)
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  • Transition of Care Associate, Licensed Practical…

    CVS Health (Trenton, NJ)
    …TOC team will review prior claims to address potential impact on current case management and eligibility status. Assessments and/or questionnaires are designed ... 8:00 AM - 5:00 PM Eastern Standard Time (EST)_ ** Travel :** U _p to 25% in New Jersey_ Help...impact on our members, who are enrolled in Care Management and present with a wide range of complex… more
    CVS Health (08/01/25)
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