• Medical Director - Claims

    Humana (Trenton, NJ)
    …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (11/01/25)
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  • PCO Medical Director - UM - Full…

    CenterWell (Trenton, NJ)
    …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
    CenterWell (11/06/25)
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  • Medical Director - Medicaid N.…

    Humana (Trenton, NJ)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (10/25/25)
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  • Medical Director - Nat'l UM IP (4x10…

    Humana (Trenton, NJ)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (11/07/25)
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  • Director Claims

    Ryder System (Trenton, NJ)
    …clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Director Claims directs activities within the General and ... Auto Liability Claims , Physical Damage Repairs and Property and Cargo Claims including the management of loss control activities and third-party provider… more
    Ryder System (11/22/25)
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  • Medical Director , Medicare…

    Humana (Trenton, NJ)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (11/19/25)
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  • Associate Medical Director

    Ascendis Pharma (Princeton, NJ)
    …Associate Medical Director supports the US Medical Director for deliverables and activities associated with management and implementation of phase ... + Ensure the materials are medically accurate, including that claims are appropriately supported by evidence, references are correctly...and other functional group contributors to support the US Medical Director in successful management more
    Ascendis Pharma (10/30/25)
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  • Executive Director , Medical Affairs…

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    As a senior leader within Medical Affairs, the Executive Director will serve as a strategic thought partner and Chief of Staff to the Vice President of ... capabilities aligned with Otsuka's vision, direction, and growth strategy. The Executive Director , Medical Affairs Strategy, Excellence & Operations will lead… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Director , Strategic Planning & Operations…

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    …the asset lifecycle. This role reports directly into the Executive Director , Medical Excellence and Operations. **Job Description** **Key Responsibilities ... The Director , Strategic Planning & Operations is a pivotal...multi-year strategic roadmaps tailored to each therapeutic area **Budget Management ** + Oversee budgets for global medical more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Medical Director Aetna Duals Center…

    CVS Health (Trenton, NJ)
    …cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a medical director to be part of a...licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another Health… more
    CVS Health (11/13/25)
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  • Director , Congress & Medical

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    The Director , Congress and Medical Education Strategy & Execution is responsible for developing and leading the global medical strategy and tactical ... outcomes through deep scientific understanding and collaborative partnerships. The Director partners closely with global and regional cross-functional stakeholders -… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Director Pre Appeals Management -HSO…

    Mount Sinai Health System (New York, NY)
    …patient outcomes while controlling costs. The Director collaborates closely with medical staff, vendors, case management , and payers to secure payment and ... **Job Description** ** Director Pre Appeals Management -HSO Appeals ...**Preferred Qualifications (Industry-Specific)** : + Healthcare: Experience with utilization management for medical services, procedures, or medications… more
    Mount Sinai Health System (11/01/25)
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  • Associate Director , Business Development…

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    The Associate Director , Business Development - Project Management will support global business development transactions. The candidate should have a scientific ... background and project management experience, capable of overseeing cross-functional teams and driving...a minimum of 5 business days. **Company benefits:** Comprehensive medical , dental, vision, prescription drug coverage, company provided basic… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Associate Director , R&D Strategic…

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    **The R&D Strategic Sourcing Associate Director ,** Supplier Relationship Management is a pivotal role responsible for ensuring compliance with procurement ... policies and processes governing Otsuka's supplier management practices. This individual will collaborate closely with internal and external partners within the R&D… more
    Otsuka America Pharmaceutical Inc. (11/20/25)
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  • Associate Director , Commercial Strategic…

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    The Commercial Sourcing Associate Director , Supplier Relationship Management is a pivotal role responsible for ensuring compliance with procurement policies and ... processes governing Otsuka's supplier management practices. This individual will collaborate closely with internal and external partners within the Commercial… more
    Otsuka America Pharmaceutical Inc. (09/30/25)
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  • Remote Medical Director

    Centene Corporation (New York, NY)
    …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
    Centene Corporation (11/15/25)
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  • Director , Global Medical Training…

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    **Job Summary** The Director , Global Medical Training & Field Excellence will lead the development and execution of strategic training programs and field ... excellence initiatives across Global Medical Affairs. This role is responsible for building capabilities, driving consistency, and enhancing performance across both… more
    Otsuka America Pharmaceutical Inc. (11/18/25)
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  • Associate Director of Quality - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …and strategic business needs (eg, market sizing), and healthcare topics (eg, claims analysis) with guidance from Quality Director ? Effective communicator ... strong reputation for quality of care (18th ranked academic medical center) and research/education (22nd ranked medical ...transition to a business model focused on population health management - our goal is to keep entire communities… more
    Mount Sinai Health System (11/20/25)
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  • Senior Director , Corporate Compliance,…

    United Therapeutics (Trenton, NJ)
    …compliance risks and responds effectively and efficiently. The Senior Corporate Compliance Director , Risk Management reports to the Chief Compliance Officer and ... is responsible for leading the Department's risk management activities. The Senior Corporate Compliance Director will develop the auditing and monitoring… more
    United Therapeutics (11/17/25)
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  • Program Management Director

    AECOM (New York, NY)
    …**Job Description** **AECOM Technical Services is currently looking for an experienced Program Management Director to join our team, leading on a complex program ... for ethical and safe working practices. + Drives innovation in program management approaches and methodology to achieve marketplace differentiation. + Works with… more
    AECOM (09/11/25)
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