- Hunterdon Health Care System (Flemington, NJ)
- This is an in-person role. Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- Terumo Medical Corporation (Somerset, NJ)
- …field inventory-based modes, to include loaners, consignment, trunk stock. Field Inventory Specialist will ensure effective utilization of assets and compliance ... Field Inventory Specialist Date: Oct 23, 2025 Req ID: 4839...losses from expiry and maximize ROI, as well as review operational processes and data to identify opportunities for… more
- Cushman & Wakefield (Trenton, NJ)
- **Job Title** Procurement Specialist **Job Description Summary** Under the direction of the Procurement Leadership, this role will assist in all aspects of ... overall vendor management on the assigned client accounts. The Procurement Specialist is expected to have Procurement, Strategic Sourcing, Contracting and Analytical… more
- Datavant (Trenton, NJ)
- …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... author appeal letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers + Provide proper… more
- Sedgwick (Trenton, NJ)
- …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... Support Representatives on a variety of complex issues including expert review of International Association of Industrial Accident Boards and Commissions (IAIABC)… more
- CVS Health (Trenton, NJ)
- …We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist . The position will be a part of a specialized team who will ... all sales presentations. + Servicing of existing members and inquiries related to utilization of their product, benefits, etc. + Cross selling applicable products to… more
- Evolent (Trenton, NJ)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
- MetLife (Bridgewater, NJ)
- …strategically analyze customer data (eligible, participant, engagement, lapse, utilization ) to develop enrollment/communications strategies to drive employee ... internal organizations, including; Sales, Product COE, Distribution Development, Voluntary Specialist Director, and Marketing, to provide day-to-day support of… more
- ASM Research, An Accenture Federal Services Company (Trenton, NJ)
- …on the project in a senior administrator capacity. Considered a technical specialist in a variety of IT administrator disciplines. + Configure, monitor, and ... as needed (aside from on-call rotation). + Optimize system operations and resource utilization as well as perform system capacity analysis and planning. + Utilize… more
- GS1 US (Ewing, NJ)
- …updating, and retirement) to ensure relevance, accuracy, and effectiveness. Monitor asset utilization and coordinate regular review /update cycles. Here are a few ... badges (eg, Acclaim). + People Management: Supervise the Training Specialist role, providing coaching, performance management, and professional development support.… more