- Bristol Myers Squibb (Princeton, NJ)
- …for strategic and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, ... as well as all aspects with evaluating implications of and reporting Managed Care data required for US and Puerto Rico government pricing calculations.… more
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- Humana (Trenton, NJ)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... management. The clinical scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have discussions with external… more
- Humana (Trenton, NJ)
- …Qualifications** + **Knowledgeable in hematology and oncology** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of team or line of business. The Medical Director conducts Utilization Management of the care … more
- Humana (Trenton, NJ)
- …+ 5 years of established, post-residency clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + ... our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals.… more
- Humana (Trenton, NJ)
- …skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + ... our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The… more
- Evolent (Trenton, NJ)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to… more
- Humana (Trenton, NJ)
- …MPH, or other relevant advanced degree + Healthcare industry experience, particularly in managed care or provider sectors + Experience leading strategy projects ... and other health plans to millions. By integrating insurance with care delivery through CenterWell, Humana is improving healthcare access, coordination, and… more