- Highmark Health (Trenton, NJ)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Trenton, NJ)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Prime Therapeutics (Trenton, NJ)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Prime Therapeutics (Trenton, NJ)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Humana (Trenton, NJ)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Prime Therapeutics (Trenton, NJ)
- …our passion and drives every decision we make. **Job Posting Title** Client Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality ... Manager ensures the successful planning, implementation and execution of...provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality Rating… more
- Prime Therapeutics (Trenton, NJ)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Gentiva (Trenton, NJ)
- …lasting difference in people's lives every day. **Overview** We're looking for a **Patient Care Manager ** to join our team. **RN Clinical Manager - Hospice - FT ... not remote.** **- 2 years of Hospice RN Case Manager exp required** **- 1 year of Management/Supervisory exp...and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory… more
- Prime Therapeutics (Trenton, NJ)
- …management in the areas of problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) ... passion and drives every decision we make. **Job Posting Title** Vendor Program Manager Senior **Job Description** The Vendor Program Manager is responsible for… more
- Genesis Healthcare (Huntingdon Valley, PA)
- …this sound like you? If so, apply to join our team as a **Business Office Manager ** and take the lead in driving financial excellence at the center level! This is ... mission of delivering exceptional care. **What You'll Do:** As a Business Office Manager , you'll oversee the full spectrum of revenue cycle management functions -… more
- Datavant (Trenton, NJ)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- Genesis Healthcare (Philadelphia, PA)
- …achievement of nursing center business excellence goals as an Assistant Business Office Manager where you will complete or assist in the oversight of census, ... billing, accounts receivable, tracking of Medicaid applications and other accounts receivable functions. *Report to...other accounts receivable functions. *Report to the Business Office Manager but also receive training and support from the… more
- Centene Corporation (Trenton, NJ)
- …value, and assure integrity of records, information and systems in compliance with Company policies/standards and government regulations. + Prepare provider ... company IS system. + Monitor and oversee provider contract compliance and issue corrective action letters for non -...Experience in a healthcare or insurance environment, preferably in Medicaid . Previous experience as a lead in a functional… more
- Virtua Health (Marlton, NJ)
- …of resources. Application of appropriate medical necessity tools to maintain compliance , achieve cost effective care and positive patient outcomes. Utilizes clinical ... Workers (NASW) guidelines for documentation, while upholding patient confidentiality. Compliance - Understands and applies applicable federal and state regulatory… more
- Virtua Health (Mount Holly, NJ)
- …Six Sigma committee, department and/or divisional teams and community activities.* Compliance - understands and applies applicable federal and state requirement. ... Identify and reports compliance issues as appropriate. Position Qualifications Required / Experience...experience as Clinical Social Worker. Basic understanding of Medicare, Medicaid and managed care. Discharge planning or home health… more
- Virtua Health (Pennsauken, NJ)
- …Six Sigma committee, department and/or divisional teams and community activities. Compliance * Understands and applies applicable federal and state requirement.* ... Identify and reports compliance issues as appropriate.Position Qualifications Required / Experience Required:Required: Must be RN or Masters prepared Licensed Social… more
- Virtua Health (Pennsauken, NJ)
- …Six Sigma committee, department and/or divisional teams and community activities. Compliance - understands and applies applicable federal and state requirement. ... Identify and reports compliance issues as appropriate. Position Qualifications Required: Required Experience:...Coordination in an Acute Care setting; understanding of Medicare, Medicaid , managed care and discharge planning. (3-5 years preferred)… more
- Jewish Federation of Southern NJ (Cherry Hill, NJ)
- …staff, management and families. This role supports efficient program operations and compliance with agency and Medicaid requirements, and is responsible for ... Staff scheduling for the Jonathan Sinay Building. + Assist the Support Staff Manager with staff and client scheduling, ensuring coverage aligns with program needs. +… more
- Humana (Trenton, NJ)
- …plans. Key Accountabilities We are seeking a highly skilled Lead Digital Program Manager to oversee the development and execution of a new eCommerce business. This ... independently, ensuring alignment with strategic objectives. The Lead Digital Program Manager will play a key role in establishing the structure, frameworks,… more
- CenterWell (Trenton, NJ)
- …CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid Services (CMS), such as ACO REACH, MSSP, and future models. Under general ... operations including program administration, contract oversight, process, performance improvement, compliance , governance, training, and more. Additionally, this role will… more