- 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
- City of New York (New York, NY)
- …to fill one (1) Management Auditor II Auditor to function as a Senior Account Auditor who will: - Perform both Annual and Final closeout audits for CAMFR, ... - Review newly registered contracts to assure the accurate utilization when allocating allowable costs to its various funding...of Education and by the Council for Higher Education Accreditation (CHEA) in management , computer science, public… more
- Amazon (New York, NY)
- …Registration, Professional Engineer Registration, CEM and/or other building professional accreditation - Experience in building portfolio management and/or ... estate strategies and operations across our global fulfillment network. As a Senior Carbon Modelling Lead within the Global Realty Sustainability & Renewable Energy… more
- Evolent (Trenton, NJ)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical 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
- 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
- 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 (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 (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
- 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
- City of New York (New York, NY)
- …challenges and solutions on procurement matters; correspond with program and ACCO Senior staff for rapid solution. Participate in meetings concerning contract or ... order portfolio and provide accurate status of procurement actions. Promote increased utilization of City-Certified M/WBE vendors and assist in the achievement of… more
- 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
- Evolent (Trenton, NJ)
- …members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately ... policies + Creates adverse determination notifications that meet all accreditation , State, and Federal criteria + Uses Plain Language...identifies potential cases for Care Management programs + Communicates appropriate information to other staff… more
- City of New York (New York, NY)
- …transition from shelter into appropriate permanent housing. DHS is responsible for management of over 200 facilities, which mainly are individual and family shelters ... - Serve as the primary liaison with Program Administrators and senior stakeholders, facilitating collaboration and effective communication across teams. - Oversee… more