- Humana (Trenton, NJ)
- …The focus of this role is Medicare Pharmacy and Part D. The Senior Compliance Professional will analyze business requirements, provide research and ... caring community and help us put health first** The Senior Compliance Professional ensures ...Compliance or Health Plan Operations + Familiarity with Medicare pharmacy laws or regulations **Additional Information** Interview Format… more
- Humana (Trenton, NJ)
- …evaluation of variable factors. We are looking for an experienced Senior Compliance Professional specializing in Medicare Advantage to join our Field ... community and help us put health first** The IFG Senior Compliance Professional ensures ...cross-functional teams, including marketing, operations, and sales, to ensure compliance is integrated into all aspects of Medicare… more
- Mount Sinai Health System (New York, NY)
- …and Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a Senior Contract Compliance ( Professional Billing) Analyst who will primarily ... compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team...be responsible for tracking, trending, and analyzing professional billing (PB) contract compliance issues. This… more
- CenterWell (Trenton, NJ)
- …part of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve...will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for … more
- Humana (Trenton, NJ)
- …between Humana and its trading partners, Medicare and Medicaid. The Senior Encounter Data Management Professional will work with department leadership, ... caring community and help us put health first** The Senior Encounter Data Management Professional develops business...Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools… more
- Prime Therapeutics (Trenton, NJ)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** Job Description The ... Senior Compliance Analyst assists in the implementation...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- Prime Therapeutics (Trenton, NJ)
- …focus **Reporting Structure** + Reports to Sr Professional , Manager, Director or Senior Director in the Compliance department Potential pay for this position ... and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) -...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- Prime Therapeutics (Trenton, NJ)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** The Senior ... Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) Certified Project Management Professional (PMP)… more
- Humana (Trenton, NJ)
- …adjustment coding and documentation accuracy. The Clinical Support Team is seeking a senior professional who will be accountable for developing and maintaining ... caring community and help us put health first** The Senior Market Consultation/Partnership Professional interprets, analyzes, and...+ Help ensure accurate review of medical records for Medicare and Medicaid Risk Adjustment + Review and respond… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Senior Vendor Management Professional works as liaison between vendors and organization. The ... Senior Vendor Management Professional 's work assignments involve...liaison between vendors, internal business owners, contracting, risk, and compliance teams. As part of the Humana Military Contract… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Senior Contract Management Professional evaluates, drafts, and negotiates contracts and other ... of goods and services for Humana, its subsidiaries and affiliates. The Senior Contract Management Professional work assignments involve moderately complex to… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Senior Learning Design Professional uses instructional design, cognitive psychology and adult ... to determine the appropriate solution to a knowledge or performance gap. The Senior Learning Design Professional work assignments involve moderately complex to… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Senior Behavioral Economics Professional (SBEP) is a core member of Humana's industry-leading ... The team's work directly informs business decisions and influences broader strategies. The Senior Behavioral Economics Professional (SBEP) is a core member of… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of ... data requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Senior Financial Analyst/CDM Chargemaster -Corporate-Full-Time Days (Hybrid)** We seek an experienced Senior Financial Analyst / CDM ... Chargemaster with strong medical coding expertise to support the maintenance, compliance , and optimization of the hospital Charge Description Master (CDM). The ideal… more
- Centene Corporation (New York, NY)
- …**Position Purpose:** Creates and implements Network Transformation initiatives focused on Medicare Advantage Value Based Care Provider Relations within the New York ... results. + Identifies team skill set deficiencies and implements proper professional development plans. + Monitors Provider Performance action plans and tracks… more
- CenterWell (Trenton, NJ)
- …put health first** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist Therapeutic Subject Matter Expert monitors drug development ... factors. **Responsibilities** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist develops, maintains, and/or operationalizes strategies related… more
- Mount Sinai Health System (New York, NY)
- …and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject ... within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System...coding, modeling, and reporting on Hospital Billing (HB) and Professional Billing (PB) contracts for the MSHS Health System.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior CBO Appeals Analyst position requires an in-depth knowledge of healthcare pricing/reimbursement processes and procedures including ... institutional, as well as professional payment systems. This position is an internal subject...fashion. In collaboration with the Underpayment Team manager, the Senior CBO Appeals Analyst will work to further the… more
- Ascendis Pharma (Princeton, NJ)
- …grow and develop their skills. Ascendis Pharma is looking to hire a Senior Manager, Contract Operations to join our team. Responsibilities will include implementing ... demonstrating strong leadership, project management, and communication skills. As the Senior Manager, Contracting Operations, you will be responsible for working… more