- 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
- 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
- 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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… 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
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex...an Administrative Law Judge, support for CMS audits, cross-functional team activities, and other responsibilities as determined necessary to… more
- CenterWell (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical … 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
- 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
- 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
- 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
- J&J Family of Companies (Titusville, NJ)
- …to fulfillment, on-boarding, and adherence. Johnson & Johnson Innovative Medicine's PECS team is recruiting for a ** Director , PECS Marketing & Branding ... messaging in market across all Therapeutic Area (TA) patient support programs (PSP). The Director will lead a team of 2 direct reports that collectively will… 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
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Associate Director of Design Research provides leadership on research strategy and execution, uncovering ... collaborates with leaders across design, product, and analytics, and leads a team of researchers to develop differentiating user-centered solutions in the Plan… more
- Grifols Shared Services North America, Inc (Trenton, NJ)
- Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global ... and services in more than 110 countries and regions. The Associate Director , Value Access Marketing & Reimbursement is responsible for developing and executing… more
- Ascendis Pharma (Princeton, NJ)
- …in the US, Germany & Austria, with plans for rapid expansion. As our new Director of Pricing Policy and Analytics, you will be evaluating the impact of policy on ... an advanced analytics arm for the Pricing & Contracting team within the US, Ascendis' largest affiliate. You will...largest affiliate. You will report directly to the Sr. Director , Pricing & Contracting Strategy and be based in… more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Associate Director , Business Intelligence solves complex business problems and issues using data from ... external sources to provide insight to decision-makers. The Associate Director , Business Intelligence requires a solid understanding of how...applications, and data resources. The role will lead a team of up to approx. 7-9 direct associates. **Key… more