- AIG (Jersey City, NJ)
- Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within ... an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability...+ 7+ years of medical malpractice / professional liability complex claims and/or complex litigation… more
- Humana (Trenton, NJ)
- …understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- … will lead a small team of experienced employee relations experts who together solve complex problems on a regular basis. The Director is expected to stay ... **Job Summary** Otsuka Pharmaceutical Company is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health… more
- Humana (Trenton, NJ)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Humana (Trenton, NJ)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Evolent (Trenton, NJ)
- …Management** and **Product Management** , leveraging advanced analytics to solve complex healthcare challenges and support impactful decision-making that ... Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Evolent (Trenton, NJ)
- …or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...+ At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- Elevance Health (Woodbridge, NJ)
- …payment integrity, or provider performance programs preferred. + Strong understanding of healthcare data systems ( claims , EHR, analytics platforms) and payer ... **Manager, Medical Director - Transformation Initiatives** Location: This role requires...initiatives that impact providers, members, and clients across the healthcare ecosystem. **How you will make an impact:** **Strategic… more
- Evolent (Trenton, NJ)
- …rates, turnaround times, PMPM, trend drivers), with a working knowledge of healthcare claims and reimbursement methodologies. + Experience presenting actionable ... Be Doing: + Strategic Data Analytics & Insights: Lead advanced analyses of healthcare authorization, claims , membership data, and clinical outcomes to uncover… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- Otsuka is a global healthcare company that has been in business for more than 100 years driven by the corporate philosophy: "Otsuka people creating new products for ... research programs targeting various unmet specialty disease areas. The Executive Director , Compliance Program Optimization (CPO), will facilitate execution of the… more
- Merck (Rahway, NJ)
- … healthcare data, including but not limited to administrative claims , EHR/EMR, disease registry, and public-use databases. Develop machine learning algorithms ... are seeking a highly skilled and motivated Associate Principal Scientist/Associate Director with expertise in conducting outcome researching using real world data.… more
- Humana (Trenton, NJ)
- …Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness and… more
- Otsuka America Pharmaceutical Inc. (Trenton, NJ)
- The Director , Strategy & Analysis and Contract Operations is responsible for directing and conducting pricing analysis of government policy and evaluating pricing ... Access, or payer experience + Thorough understanding and knowledge of US healthcare economics and the drivers of pharmaceutical demand, including pricing and… more
- Bristol Myers Squibb (Princeton, NJ)
- …personal lives. Read more: careers.bms.com/working-with-us . **Position:** Director , US Medical Promotional Review Scientist, Immunology/Cardiovascular **Location** ... : Princeton, NJ (Hybrid role) The Director , US Medical Promotional Review Scientist (Immunology and/or Cardiovascular), plays a critical role in the Medical… more
- J&J Family of Companies (Titusville, NJ)
- …Ph.D. is highly preferred. **Competencies:** + Proven experience working with healthcare claims , electronic health records (EHRs), and specialty pharmacy ... Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where... innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments… more
- BD (Becton, Dickinson and Company) (Franklin Lakes, NJ)
- **Job Description Summary** The Associate Director of Marketing Excellence leads and oversees product marketing to ensure commercial success by aligning product ... Solutions (MDS) business unit. This role demands a strong understanding of healthcare audiences and regulatory environments, along with the ability to simplify … more
- Bristol Myers Squibb (Princeton, NJ)
- …patient access to medications and treatment. As a key contributor, the Associate Director will lead complex and high-volume program launches and management ... their personal lives. Read more: careers.bms.com/working-with-us . **SUMMARY:** The Associate Director , PASS Program Strategy and Marketing will play a critical role… more
- Humana (Trenton, NJ)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- J&J Family of Companies (Titusville, NJ)
- At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, ... we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact… more
- Sanofi Group (Morristown, NJ)
- **Job Title:** Director , Global Regulatory Affairs - Global Labeling Strategy **Location:** Morristown, NJ Cambridge, MA **About the Job** Are you ready to shape the ... Your skills could be critical in helping our teams accelerate progress. The Director , Global Regulatory Affairs - Global Labeling Strategy is responsible for leading… more