- Evolent (Trenton, NJ)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Clinical Rules Management , Analyst ** Seeking a detail-oriented ** ... Clinical Rules Management , Analyst ** who will play a critical role in ensuring the accuracy and integrity of our clinical rule engine, impacting our … more
- Highmark Health (Trenton, NJ)
- …job works collaboratively riskacross Highmark Health clinical areas to support clinical quality auditing, The Senior Risk Compliance Analyst is responsible ... subject matter expert, providing insights and guidance to internal departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and… more
- Highmark Health (Trenton, NJ)
- …well as taking technical direction from and supporting the Lead Cost Accounting Analyst with respect to cost allocation rules and system processes required.80% ... and reporting associated with the organization's financial, operational, and/or clinical performance. As such, this role generates audience-specific summaries of… more
- Intermountain Health (Trenton, NJ)
- **Job Description:** The RCO Rev Integrity Chargemaster Analyst II independently handles EPIC build, maintenance, and implementation of charge codes, fee schedules, ... and mentor teammates, provide education and guidance to revenue cycle and clinical teams, and assists with testing and validation. Supports and collaborates with… more
- New York State Civil Service (New York, NY)
- …HELP No Agency Attorney General, Office of the Title Legal Nurse/Medical Analyst :Medicaid Fraud Control Unit (6388) Occupational Category Legal Salary Grade NS ... Medicaid Fraud Control Unit - New York City Medical Analyst , Opportunity for Registered NursesReference No. MFCU_NYC_ MA_6388Salary is...license; * A minimum of seven (7) years of clinical experience; * Knowledge of the current standards and… more
- Virtua Health (Mount Laurel, NJ)
- …Revenue Integrity Team, Clinical Operations and IT to help ensure workqueue rules are accurate and updated based on annual and quarterly coding changes. Assist ... charge capture accuracy. Incumbent must develop close working relationships with management and staff in Revenue Integrity, Finance, Information Technology and… more
- Cardinal Health (Trenton, NJ)
- … team to onboard new practices including Assessment Call and giving direction to Clinical Analyst owning account * Once the Rheum team grows, manage the ... training and oversite of all new Clinical Analyst Team members (working with HR,...Specialty Network requirements of the Provider Solutions, Customer Success, management , and HR Handbook rules * Assist… more
- CenterWell (Trenton, NJ)
- …Senior Strategy Advancement Professional will bring a combination of operational support, analyst skills, and strategy oversight to the role. This individual will ... Medicare, population health, Accountable Care Organizations (ACOs), medical group management / practice management , health plans /...necessary / required actions initiated by CMS * Oversee rules and regulations of ACO programs as outlined in… more