• Director Medicare / Medicaid

    Robert Half Finance & Accounting (Eatontown, NJ)
    …company located in Eatontown and offers a hybrid schedule, has an opportunity for a Director Medicare / Medicaid Reimbursement . + The Director will ... above. + Planning, preparing and reviewing of the annual Medicare / Medicaid cost reports filings. In partnership with...the Vice President of Corporate Reimbursement , the Director will manage the completion of DSH, Medicare more
    Robert Half Finance & Accounting (06/24/25)
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  • Senior Market Access Director

    Amneal Pharmaceuticals (Bridgewater, NJ)
    …as unique business segments such as specialty and retail pharmacy and state Medicaid organizationsThe Sr. Director is a cross-functional leadership role that is ... Description: The Senior Director of Market Access Strategy is responsible for...Pharmacy benefit formularies, across all lines of business (Commercial, Medicare , & Managed Medicaid ), as well as… more
    Amneal Pharmaceuticals (05/08/25)
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  • Executive Director , Data Analytics…

    City of New York (New York, NY)
    …millions of dollars in annual Medicaid spending. This work includes identifying Medicaid clients who should apply for Medicare , identifying Medicaid ... Staff Analyst NM III to function as an Executive Director , Data Analytics & Verification who will: - Oversee...and implement the process to evaluate claims for skimming reimbursement in a batch, data-driven manner, with 100% accuracy… more
    City of New York (05/14/25)
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  • Associate Director , Customer Service…

    Humana (Trenton, NJ)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... community and help us put health first** The Associate Director , Customer Service & Retention is responsible for member...of customer service & retention management experience in the Medicare Advantage space + Strong technical experience + Strong… more
    Humana (07/16/25)
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  • Director , Pricing Policy and Analytics…

    Ascendis Pharma (Princeton, NJ)
    …innovative pricing models. + Familiarity with pharmaceutical policy impacts from IRA, Medicaid / Medicare rules, and global price referencing. + Proficiency with ... in the US, Germany & Austria, with plans for rapid expansion. As our new Director of Pricing Policy and Analytics, you will be evaluating the impact of policy on… more
    Ascendis Pharma (06/10/25)
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  • Medical Director - Commercial Appeals

    CVS Health (Trenton, NJ)
    …Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical, coding, and reimbursement expertise as well ... to obtain an AZ medical license. Internal Medicine background Have experience in Medicare and Medicaid **Education** *M.D. or DO, Board Certification in an… more
    CVS Health (07/04/25)
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  • Medical Director - Dsnp/MMP

    CVS Health (Trenton, NJ)
    …clinical oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare - Medicaid Plan) * Develop and lead clinical strategy and ... Leverage extensive knowledge of health care delivery system, utilization management, reimbursement methods and treatment protocols for DSNP/MMP and other complex… more
    CVS Health (07/13/25)
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  • Director , Finance Gross-to-Net Reporting…

    Ascendis Pharma (Princeton, NJ)
    …and reporting. + Deep expertise in US Federal and State Pricing Programs ( Medicaid , Medicare , FSS, PHS340B) and related regulations. + Deep experience working ... for employees to grow and develop their skills. Position Summary The Director , Finance Gross-to-Net (GTN) Reporting will lead the development, execution, and… more
    Ascendis Pharma (07/12/25)
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  • Director , Government Channel Lead

    Bristol Myers Squibb (Princeton, NJ)
    …Channel Lead will manage forecasting and analytics for government channels, including Medicaid , Medicare , and other Federal customers. This role coordinates ... military leave. Family care services such as adoption and surrogacy reimbursement , fertility/infertility benefits, support for traveling mothers, and child, elder… more
    Bristol Myers Squibb (07/15/25)
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  • (Senior) Manager, Market Access…

    ConvaTec (Bridgewater, NJ)
    …of the newly formed Market Access COE and report into the Senior Director , Market Access and Reimbursement . **Key Responsibilities:** + Lead payer engagement ... visit http://www.convatecgroup.com **Position Overview:** The Senior Market Access & Reimbursement will drive reimbursement strategy for Advanced...strategies in the US for Medicare , Medicaid and private insurers to secure… more
    ConvaTec (07/04/25)
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  • RN Clinical Manager - Hospice - FT - Mon-Fri - 8a…

    Gentiva (Piscataway, NJ)
    …and practice, including industry standards, regulations, and best practices (ie, Medicare , Medicaid , JCAHO, ACHC), company policies/procedures, and understanding ... + Mileage or Fleet Car Program + Cell Phone Reimbursement (for eligible roles) + Short Term Incentive (for...join our team.You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will… more
    Gentiva (07/15/25)
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  • Provider Contracts Manager (Behavioral Health)

    Molina Healthcare (New York, NY)
    …familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not ... marketable providers. Contract/Re-contracting with large scale entities involving custom reimbursement . Executes standardized Alternative Payment Method contracts. Issue escalations,… more
    Molina Healthcare (06/22/25)
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  • Sr. Compliance Manager - Monitoring & Transparency

    Terumo Medical Corporation (Somerset, NJ)
    …federal and state transparency reporting, and manages reporting functions in (Centers for Medicare & Medicaid Services (CMS). Performs analytics on CMS available ... Summary** The Senior Compliance Manager -Monitoring & Transparency, will support the Director - Healthcare Compliance of Terumo Americas Holding and its managed… more
    Terumo Medical Corporation (05/13/25)
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  • Senior Manager, Contracting Operations - Job ID:

    Ascendis Pharma (Princeton, NJ)
    …customers including private and public payers, national and regional health plans, state Medicaid , Medicare Part B and D, VA/DOD, PBM's, Employers, IDNs, Medical ... NJ three (3) days/week and will report directly to the Director , Contracting Operations. Requirements Key Responsibilities: Rebate Management . Administer and… more
    Ascendis Pharma (07/08/25)
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  • Manager Revenue Cycle Operations

    Hunterdon Health Care System (Flemington, NJ)
    …medical billing experience + Chargemaster experience required + Experience working with Medicare , Medicaid , and private insurance contracts - understanding and ... Acute Care billings (hospital) under the direction of the Director of the SBO. . Maintains an efficient billing...medical, dental, vision, family forming, paid time off, tuition reimbursement , and retirement savings. The hiring range listed is… more
    Hunterdon Health Care System (05/30/25)
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  • Senior CBO Appeals Analyst

    Mount Sinai Health System (New York, NY)
    …on KPI's. 7. Research and analyze impacts of various State and Federal Medicare and Medicaid policies, regulations, legislation and other proposals, including ... Appeals Analyst position requires an in-depth knowledge of healthcare pricing/ reimbursement processes and procedures including institutional, as well as professional… more
    Mount Sinai Health System (05/17/25)
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  • Patient Access Specialist - Per Diem - Evening

    Hackensack Meridian Health (Belle Mead, NJ)
    …patient demographics to validate patient identity. Conducts intensive screening of all Medicare , Medicaid and managed care patients to identify network status ... team here at Hackensack Meridian Health! We offer Scheduling Flexibility, Tuition Reimbursement , Employee Discounts and much more The Patient Access Specialist is… more
    Hackensack Meridian Health (07/04/25)
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  • Patient Access Specialist - Part Time - Night

    Hackensack Meridian Health (Belle Mead, NJ)
    …patient demographics to validate patient identity. Conducts intensive screening of all Medicare , Medicaid and managed care patients to identify network status ... Meridian Health! We offer EXCELLENT benefits, Scheduling Flexibility, Tuition Reimbursement , Employee Discounts and much more The Patient Access Specialist… more
    Hackensack Meridian Health (06/20/25)
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  • Specialty Pharmacy Financial Access Coordinator,…

    Mount Sinai Health System (New York, NY)
    …procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health ... **Job Description** Under direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager...payer plans and how they are processed, of medication reimbursement , including the prior authorization process, proficiency in the… more
    Mount Sinai Health System (07/09/25)
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  • Hospice Patient Care Manager - Clinical Manager RN

    Gentiva (Hamilton, NJ)
    …and practice, including industry standards, regulations, and best practices (ie, Medicare , Medicaid , JCAHO, ACHC), company policies/procedures, and understanding ... hospice team in Hamilton, NJ. You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will be responsible for… more
    Gentiva (07/16/25)
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