- AIG (Jersey City, NJ)
- Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within ... an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability...+ 7+ years of medical malpractice / professional liability complex claims and/or complex litigation… more
- Kyndryl (Trenton, NJ)
- …a key leadership role across multi-disciplinary teams, guiding them through complex consulting engagements and be responsible for creating and positioning strategic ... Kyndryl's largest accounts across the C-suite, spanning the intersection between complex Business and IT customer solutions, transformations that impact across the… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- … will lead a small team of experienced employee relations experts who together solve complex problems on a regular basis. The Director is expected to stay ... **Job Summary** Otsuka Pharmaceutical Company is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health… more
- Humana (Trenton, NJ)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Humana (Trenton, NJ)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Evolent (Trenton, NJ)
- …Management** and **Product Management** , leveraging advanced analytics to solve complex healthcare challenges and support impactful decision-making that ... Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Evolent (Trenton, NJ)
- …or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...+ At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- Elevance Health (Woodbridge, NJ)
- …payment integrity, or provider performance programs preferred. + Strong understanding of healthcare data systems ( claims , EHR, analytics platforms) and payer ... **Manager, Medical Director - Transformation Initiatives** Location: This role requires...initiatives that impact providers, members, and clients across the healthcare ecosystem. **How you will make an impact:** **Strategic… more
- Evolent (Trenton, NJ)
- …rates, turnaround times, PMPM, trend drivers), with a working knowledge of healthcare claims and reimbursement methodologies. + Experience presenting actionable ... Be Doing: + Strategic Data Analytics & Insights: Lead advanced analyses of healthcare authorization, claims , membership data, and clinical outcomes to uncover… more
- RWJBarnabas Health (Oceanport, NJ)
- Director , Revenue Cycle Automation and OptimizationReq #:0000202284 Category: Healthcare Operations, Revenue Cycle, and Patient Access Status:Full-Time Shift:Day ... per year Location: 2 Crescent Place, Oceanport, NJ 07757 Job Title: Director , Revenue Cycle Automation and Optimization Location: Hybrid - Barnabas Health Corp… more
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