- 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- CVS Health (Trenton, NJ)
- …We are looking for a Principal Data Scientist to join our Aetna Medicare (STARS Portfolio) team at CVS Health. This high-level individual contributor will partner ... closely with the Executive Director of Aetna STARS Analytics to drive hands on...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … 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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Evolent (Trenton, NJ)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Trenton, NJ)
- …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. ... 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)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... 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 Field Medical Director , Oncology, you will be a key member of the utilization management ... recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Evolent (Trenton, NJ)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Amneal Pharmaceuticals (Bridgewater, NJ)
- …Business Operations and Legal/Compliance. The Director will partner with the National Director Leaders, Trade Team, Brand Leaders and Pricing Organization to ... Description: The Senior Director of Market Access Strategy is responsible for...formulary access go-to-market strategies and executional plans across both medical and pharmacy benefits, as well as unique business… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Health System/Goryeb Children's Hospital is Seeking a Program Director for our Pediatric Residency Training Program located in Morristown, New Jersey The ... Health System, is a branch campus of Sidney Kimmel Medical College at Thomas Jefferson University. The role of...College at Thomas Jefferson University. The role of Program Director involves a commitment of 60% administrative responsibilities and… more
- Daiichi Sankyo Inc. (Basking Ridge, NJ)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... areas centered around rare diseases and immune disorders. **Summary:** The Associate Director , Oncology Value & Market Dynamics Training Manager is responsible for… more
- Evolent (Trenton, NJ)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... in Cardiology** (with Cardiology training and clinical experience). + **Unrestricted medical license** in the state of residence and willingness to obtain… more
- CVS Health (Trenton, NJ)
- …it all with heart, each and every day. **Position Summary** As the Lead Director , DSNP Program Management you will plan, monitor and manage internal projects from ... that provides specialized care for individuals who are eligible for both Medicare and Medicaid (dual eligible beneficiaries). + Manage projects to ensure on-time… more
- United Methodist Communities (Newton, NJ)
- …Dr, Newton, NJ 07860, USA | Salary | 167591 per year | Full Time Executive Director Senior Living Full Time ** Pay rate up to $167,591/year** UMC has been certified ... in the work that they do at UMC! UMC is currently seeking an Executive Director for our Bristol Glen Senior Care Community located in Newton, NJ. Bristol Glen, a… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Director , Managed Care Payer Contracting (V&A) Date: May 6, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 61853 ... a difference, and new people to make a difference with. **The opportunity** The Director , Managed Care Payer Contracting is a key leadership role within Value &… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …Drafting: + Author and manage the lifecycle of National pharmacy and medical benefit payer contracts, including Commercial, Medicare and Managed Medicaid + ... Associate Director , Managed Care Payer Contracting (V&A) Date: May...or health insurance industry preferred) + Contracting experience with National GPO and PBM customers + Proven ability to… more