• Novo Nordisk Inc. (Plainsboro, NJ)
    …us? The Position The Senior Manager - Market Access Insights works with the Director - Market Access Insights to explore key market access topics of interest and ... Conducts longitudinal patient-level data analyses, integrates formulary data and payer utilization dynamics to inform the organization on level of access, payer… more
    HireLifeScience (06/03/25)
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  • National Utilization

    Humana (Trenton, NJ)
    **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
    Humana (06/06/25)
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  • AVP, Utilization Review & Pharmacy

    Zurich NA (Trenton, NJ)
    …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
    Zurich NA (05/22/25)
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  • Medical Director - Medicaid N. Central

    Humana (Trenton, NJ)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/14/25)
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  • Medical Director , MSK Surgery

    Evolent (Trenton, NJ)
    …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
    Evolent (05/20/25)
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  • Field Medical Director , Interventional…

    Evolent (Trenton, NJ)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (04/30/25)
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  • Medical Director - Care Plus - Florida

    Humana (Trenton, NJ)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (04/24/25)
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  • Medical Director - Florida

    Humana (Trenton, NJ)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (06/05/25)
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  • Medical Director - OneHome

    Humana (Trenton, NJ)
    …Medical Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/31/25)
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  • Field Medical Director , Vascular Surgery

    Evolent (Trenton, NJ)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... 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 (06/06/25)
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  • Field Medical Director , Cardiology

    Evolent (Trenton, NJ)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... 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 (05/16/25)
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  • Regional Field Director , RNS Program…

    United Therapeutics (Trenton, NJ)
    …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
    United Therapeutics (06/05/25)
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  • Medical Director -Payment Integrity

    Humana (Trenton, NJ)
    …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (06/06/25)
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  • Field Medical Director , Physical Medicine…

    Evolent (Trenton, NJ)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Rehab 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 (05/30/25)
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  • Field Medical Director , Oncology

    Evolent (Trenton, NJ)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, 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 (05/20/25)
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  • Director of Asset Management

    Inframark, LLC (Horsham, PA)
    …US + Assist in the standardization and implementation of computerized maintenance management systems (CMMS), ensuring data integrity, utilization , and continuous ... and Responsibilities** + Assist in the development of the strategic direction of Inframark's asset management and reliability programs across all O&M projects in the… more
    Inframark, LLC (06/05/25)
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  • Associate Director , Thought Leader…

    J&J Family of Companies (Horsham, PA)
    …**Job Description:** We are searching for the best talent for an Associate Director , Thought Leader Liaison, Neurology Rare Disease to support the Northeast Region. ... for the candidate to reside in the assigned region with easy access to a national airport. This is a field-based role available in all states within the United… more
    J&J Family of Companies (05/23/25)
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  • Medical Director - New Jersey Market

    CVS Health (Trenton, NJ)
    …ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality ... Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...ability to obtain a NJ License. In the Medical Director role you will provide oversight for medical policy… more
    CVS Health (06/04/25)
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  • Associate Director , Client Analytics

    Evolent (Trenton, NJ)
    …leadership is preferred. + Familiarity with value-based care models and utilization management frameworks is preferred. **Technical Requirements:** We require ... of our specialty programs and administrative platform. **Role Overview** The Associate Director role on Client Analytics will support both internal teams (EAS,… more
    Evolent (05/01/25)
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  • Associate Director , Channel Strategy…

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    **Associate Director , Channel Strategy and Patient Affordability** The Associate Director , Channel Strategy and Patient Affordability reports to the Executive ... Director , Channel Strategy and Patient Affordability. The Associate ...resources effectively across the team to ensure efficient budget utilization , while identifying cost saving opportunities + Design operational… more
    Otsuka America Pharmaceutical Inc. (05/29/25)
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