- Aveanna Healthcare (Clark, NJ)
- …for you when you come to Aveanna. Position Overview The Clinical Director is responsible and accountable for the planning, organizing, directing and evaluating ... nursing services of nursing location (non-PDHC offices). The Clinical Director (CD) is responsible for the management of all operational services for their location… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Trenton, NJ)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- CVS Health (Trenton, NJ)
- …Home" position primarily supporting the Aetna Northeast Medicaid plan and the UM team . The UM Medical Director will ensure timely and consistent ... and every day. **Position Summary:** Ready to take your Medical Director skills to the next level...opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, Florida,… more
- Humana (Trenton, NJ)
- …party reporting including notification, collection, analyze, storage, and distribution. + Team representative and presenter for various Medicaid committee ... caring community and help us put health first** The Associate Director , Procurement generates and implements efficient sourcing and category management strategies.… more
- New York State Civil Service (New York, NY)
- …No Agency Attorney General, Office of the Title Legal Nurse: Investigate Medicaid Fraud/Patient Abuse (6400) Occupational Category Legal Salary Grade NS Bargaining ... Office of the New York State Attorney General's (OAG) Medicaid Fraud Control Unit (MFCU) is seeking experienced Registered...(MFCU) is seeking experienced Registered Nurses to serve as Medical Analysts in its New York City office. … more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- Humana (Trenton, NJ)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture + Knowledge and experience with national guidelines… more
- Humana (Trenton, NJ)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture** + **Knowledge and experience with national guidelines… more
- Evolent (Trenton, NJ)
- …meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Trenton, NJ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management ... team . We can offer you a meaningful way to...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Centene Corporation (New York, NY)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... 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
- Evolent (Trenton, NJ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... team . We can offer you a meaningful way to...timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to… more
- Mount Sinai Health System (New York, NY)
- …Description** **The Mount Sinai Health System seeks an Obstetrics and Gynecology System Medical Director for its Ambulatory Services at Mount Sinai Hospital!** ... status for nursing care, and it is the only medical center in New York State to earn Disease-Specific...Care Innovation Award from the Centers for Medicare and Medicaid Services to open the first geriatric emergency department… more
- Ascendis Pharma (Princeton, NJ)
- … Director , Market Access Contract Operations to join our team . Responsibilities will include implementing market access pricing & contracting strategies ... mission of developing new and potentially best-in-class therapies to address unmet medical needs. Our culture fosters a place where skilled, adaptable, and highly… more
- Evolent (Trenton, NJ)
- …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... will be a key member of the utilization management team . We can offer you a meaningful way to...Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Vibrant Emotional Health (New York, NY)
- Position Title: Senior Director of Clinical Services Department: Community Services Reports to: Vice President of Community Programs Location: (Remote/In-House) ... wellness can be a reality for everyone. Position Overview The Senior Director will be responsible for leading and transforming Mental Health Service Delivery… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …territory account managers and HEOR/ medical + Responsible for supporting the Sr. Director , Federal National Accounts & Medicaid in speed to access and gross ... The Associate Director of Federal Account Management reports to the Senior Director Federal National Accounts and Medicaid and is responsible for strategic… more
- Ascendis Pharma (Princeton, NJ)
- …mission of developing new and potentially best-in-class therapies to address unmet medical needs. Our culture fosters a place where skilled, adaptable, and highly ... for employees to grow and develop their skills. The Director , Government Pricing will lead the development, execution, and...and annual GP reports to CMS, VA/DoD, and state Medicaid agencies, and any programs requiring price reporting, per… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Associate Director , Managed Care Payer Contracting Date: Oct 17, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: ... chance to leverage your expertise, drive impactful agreements, and contribute to a team that's defining the next generation of pharmaceutical access in a high-growth… more
