• Director Medicare / Medicaid

    Robert Half Finance & Accounting (Eatontown, NJ)
    …company located in Eatontown and offers a hybrid schedule, has an opportunity for a Director Medicare / Medicaid Reimbursement . + The Director will ... above. + Planning, preparing and reviewing of the annual Medicare / Medicaid cost reports filings. In partnership with...the Vice President of Corporate Reimbursement , the Director will manage the completion of DSH, Medicare more
    Robert Half Finance & Accounting (06/24/25)
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  • Director , Field Reimbursement

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    …compliance and risk management Preferred Skills + Comprehensive knowledge of Medicare , Medicaid , and commercial insurance reimbursement regulations ... Director , Field Reimbursement Management (FRM) Position Overview We are seeking an experienced, transformative leader to serve as the Director , Field … more
    Otsuka America Pharmaceutical Inc. (07/10/25)
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  • Executive Director , Data Analytics…

    City of New York (New York, NY)
    …millions of dollars in annual Medicaid spending. This work includes identifying Medicaid clients who should apply for Medicare , identifying Medicaid ... Staff Analyst NM III to function as an Executive Director , Data Analytics & Verification who will: - Oversee...and implement the process to evaluate claims for skimming reimbursement in a batch, data-driven manner, with 100% accuracy… more
    City of New York (05/14/25)
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  • Director , Pricing Policy and Analytics…

    Ascendis Pharma (Princeton, NJ)
    …innovative pricing models. + Familiarity with pharmaceutical policy impacts from IRA, Medicaid / Medicare rules, and global price referencing. + Proficiency with ... 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… more
    Ascendis Pharma (06/10/25)
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  • Medical Director - Commercial Appeals

    CVS Health (Trenton, NJ)
    …Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical, coding, and reimbursement expertise as well ... to obtain an AZ medical license. Internal Medicine background Have experience in Medicare and Medicaid **Education** *M.D. or DO, Board Certification in an… more
    CVS Health (07/04/25)
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  • Medical Director - Dsnp/MMP

    CVS Health (Trenton, NJ)
    …clinical oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare - Medicaid Plan) * Develop and lead clinical strategy and ... Leverage extensive knowledge of health care delivery system, utilization management, reimbursement methods and treatment protocols for DSNP/MMP and other complex… more
    CVS Health (07/13/25)
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  • Director , Finance Gross-to-Net Reporting…

    Ascendis Pharma (Princeton, NJ)
    …and reporting. + Deep expertise in US Federal and State Pricing Programs ( Medicaid , Medicare , FSS, PHS340B) and related regulations. + Deep experience working ... for employees to grow and develop their skills. Position Summary The Director , Finance Gross-to-Net (GTN) Reporting will lead the development, execution, and… more
    Ascendis Pharma (07/12/25)
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  • Director , Government Channel Lead

    Bristol Myers Squibb (Princeton, NJ)
    …Channel Lead will manage forecasting and analytics for government channels, including Medicaid , Medicare , and other Federal customers. This role coordinates ... military leave. Family care services such as adoption and surrogacy reimbursement , fertility/infertility benefits, support for traveling mothers, and child, elder… more
    Bristol Myers Squibb (07/15/25)
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  • Provider Contracts Manager (Behavioral Health)

    Molina Healthcare (New York, NY)
    …familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not ... marketable providers. Contract/Re-contracting with large scale entities involving custom reimbursement . Executes standardized Alternative Payment Method contracts. Issue escalations,… more
    Molina Healthcare (06/22/25)
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  • Sr. Compliance Manager - Monitoring & Transparency

    Terumo Medical Corporation (Somerset, NJ)
    …federal and state transparency reporting, and manages reporting functions in (Centers for Medicare & Medicaid Services (CMS). Performs analytics on CMS available ... Summary** The Senior Compliance Manager -Monitoring & Transparency, will support the Director - Healthcare Compliance of Terumo Americas Holding and its managed… more
    Terumo Medical Corporation (05/13/25)
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  • Senior Manager, Contracting Operations - Job ID:

    Ascendis Pharma (Princeton, NJ)
    …customers including private and public payers, national and regional health plans, state Medicaid , Medicare Part B and D, VA/DOD, PBM's, Employers, IDNs, Medical ... NJ three (3) days/week and will report directly to the Director , Contracting Operations. Requirements Key Responsibilities: Rebate Management . Administer and… more
    Ascendis Pharma (07/08/25)
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  • Senior CBO Appeals Analyst

    Mount Sinai Health System (New York, NY)
    …on KPI's. 7. Research and analyze impacts of various State and Federal Medicare and Medicaid policies, regulations, legislation and other proposals, including ... Appeals Analyst position requires an in-depth knowledge of healthcare pricing/ reimbursement processes and procedures including institutional, as well as professional… more
    Mount Sinai Health System (05/17/25)
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  • Patient Access Specialist - Full Time - Evening

    Hackensack Meridian Health (Neptune City, NJ)
    …patient demographics to validate patient identity. Conducts intensive screening of all Medicare , Medicaid and managed care patients to identify network status ... Meridian Health! We offer EXCELLENT benefits, Scheduling Flexibility, Tuition Reimbursement , Employee Discounts and much more The Patient Access Specialist… more
    Hackensack Meridian Health (07/09/25)
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  • Specialty Pharmacy Financial Access Coordinator,…

    Mount Sinai Health System (New York, NY)
    …procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health ... **Job Description** Under direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager...payer plans and how they are processed, of medication reimbursement , including the prior authorization process, proficiency in the… more
    Mount Sinai Health System (07/09/25)
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  • Patient Access Specialist - Part Time - Day

    Hackensack Meridian Health (Brick, NJ)
    …patient demographics to validate patient identity. Conducts intensive screening of all Medicare , Medicaid and managed care patients to identify network status ... Meridian Health! We offer EXCELLENT benefits, Scheduling Flexibility, Tuition Reimbursement , Employee Discounts and much more The Patient Access Specialist… more
    Hackensack Meridian Health (06/20/25)
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  • Billing Administrator

    YAI (Manhattan, NY)
    …with benefits and entitlements in the healthcare and/or I/DD field including Medicaid , Medicare and applicable regulatory agencies. + Strong written and ... ensure timely and complete processing of billing and maximize reimbursement for services. + Submits billing on a monthly...information is updated in all applicable systems. + Assists Director of Revenue Management with gathering data and documents… more
    YAI (05/28/25)
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