- 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
- Teva Pharmaceuticals (North Wales, PA)
- Medicaid Claims Analyst Date: Jun 9, 2025 Location: North Wales, United States, Pennsylvania, 19454 Company: Teva Pharmaceuticals Job Id: 62333 **Who we are** ... new people to make a difference with. **The opportunity** **Position Summary:** The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which… 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
- Pearson (Trenton, NJ)
- …path through this shifting environment to achieve continued success.** _Purpose Summary_ _The Medicaid and Vendor Implementation Manager will act as the main ... Pearson Virtual Schools' Connections Academy programs. Responsibilities include ensuring compliance with federal and state Medicaid regulations, optimizing… 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
- Service Source (New Castle, DE)
- …family supports. As an integral part of the support team, the Case Manager works to move families toward self-sufficiency by linking individuals and families to ... and navigating barriers to employment. Using a wrap-around approach, the Case Manager develops care plans, continuously assesses changes in status and support needs,… more
- CenterWell (Trenton, NJ)
- …part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to ... and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require interpretation and… more
- Humana (Trenton, NJ)
- …our caring community and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. ... The Senior Data Manager work assignments involve moderately complex to complex issues...Migration -- Planning and executing data migration projects. + Compliance -- Ensuring compliance with data protection… more
- CSL Behring (King Of Prussia, PA)
- The Sr. Manager , Pricing & Government Reporting will lead the Government price reporting processes including monthly/quarterly calculations of pricing to Veteran ... (VA), Public Health Services (PHS), and Centers for Medicare and Medicaid Services (CMS). Responsible for reconciling, preparing, and analyzing federal and… more
- Humana (Trenton, NJ)
- …organization and will be critical in our growth plans. The Principal Product Manager Leads all phases of the product life cycle, from inception to introduction ... Curiosity and a human-centered approach will drive the Product Manager to find relevant data and turn it into...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… 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
- Humana (Trenton, NJ)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… 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
- Genesis Healthcare (King Of Prussia, 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
- CVS Health (Deptford, NJ)
- …can have a life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With ... needs of the member to facilitate the member's overall wellness. The ICM care manager develops a proactive plan of care to address identified issues to enhance the… more