• Senior Accreditation…

    Humana (Trenton, NJ)
    …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in...on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming … more
    Humana (05/09/25)
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  • Senior Vice President, Revenue Cycle…

    RWJBarnabas Health (Oceanport, NJ)
    …standards. + Leads payer audit response, clinical denial recovery, and utilization management integration efforts to support mid-cycle revenue integrity. ... Management Location: System Business Office, 2 Crescent Place, Oceanport, NJ 07757 Senior Vice President, Revenue Cycle Management Job Overview: The Senior… more
    RWJBarnabas Health (05/15/25)
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  • BCBA-D ABA UM Reviewer

    Humana (Trenton, NJ)
    …a part of our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work… more
    Humana (05/07/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Trenton, NJ)
    …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
    Evolent (04/30/25)
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  • Field Medical Director, Cardiology

    Evolent (Trenton, NJ)
    …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
    Evolent (05/16/25)
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  • Associate Chair of Oncology - Physician - Valley…

    Mount Sinai Health System (NJ)
    …in and support VHS initiatives in cost containment, product standardization, resources utilization and supply chain management (HIM Queries, Coding and ... vision for VMSCCC. The position will work collaboratively with senior leadership in VHS and MSHS to further develop...partner with the VMSCCC Quality Department to assure continued accreditation of Valley's cancer program by the American College… more
    Mount Sinai Health System (04/22/25)
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  • Field Medical Director, Radiology (Endocrinology)

    Evolent (Trenton, NJ)
    …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (05/03/25)
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  • Vice President of Ambulatory Operations, Jack…

    RWJBarnabas Health (New Brunswick, NJ)
    …clinics and the infusion center. The VP will work closely with other senior leaders to ensure operational effectiveness and will have direct or indirect oversight ... + A minimum of 5 years of successful progressive healthcare/facility management experience, preferably in Oncology Services + High level, complex problem-solving… more
    RWJBarnabas Health (04/26/25)
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  • Director of Community Connect

    RWJBarnabas Health (Oceanport, NJ)
    …releases and updates to help determine which features will be utilized + Provide senior management with regular status reports for all reporting areas. + Take ... revenue and expenses. + Achieve and maintain Epic Connect Accreditation on an annual basis. Team Management ...and department heads. + Provide direction and advice to senior management in anticipating the information needs… more
    RWJBarnabas Health (05/17/25)
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  • Vice President, Enterprise Master Planning…

    Hackensack Meridian Health (Edison, NJ)
    …and serve as a leader of positive change. Reporting to the Senior Vice President, Facilities, the **Vice President, Enterprise Master Planning & Construction** ... operational efficiency, improves patient care delivery, and optimizes resource utilization . **Education, Knowledge, Skills and Abilities Required:** + Bachelor's… more
    Hackensack Meridian Health (04/22/25)
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