• Medical Director -- Claims

    Humana (Trenton, NJ)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (05/08/25)
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  • Chief of Risk Management & Claims

    NJ Transit (Newark, NJ)
    Claims Admin + Director Risk Management & Insurance + Director Claims Management Education, Experience and Qualifications: + Bachelor's Degree and ... up to the amount subject to the Board of Director approval amount, managing all claim reserves and determining...the insurance industry is required. + Knowledge of risk management claims and litigation procedures in New… more
    NJ Transit (02/25/25)
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  • Global Medical Director , Evidence…

    Sanofi Group (Morristown, NJ)
    **Job title** : Global Medical Director , Evidence Generation - Insights and Strategy **Location:** Cambridge, MA, Morristown, NJ **About the Job** Sanofi's ... Evidence Generation Lead of the Next-Gen Immunology Franchise, the Medical Director will also be responsible for...expertise in developing RWE studies, as well as study management and publications. + Prior experience in claims more
    Sanofi Group (05/02/25)
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  • Medical Director - Medicaid N.…

    Humana (Trenton, NJ)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (05/14/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Care Plus…

    Humana (Trenton, NJ)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (04/24/25)
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  • Associate Director , Content…

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    …commitment to supporting access to treatment. We are looking for an **Associate** ** Director , Content Management ** as a member of the Content Management ... to deliver personalized customer journeys across channels. You will report to the Director , Omnichannel Content Management . This position is based in Princeton,… more
    Otsuka America Pharmaceutical Inc. (03/08/25)
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  • Director , Medical Affairs Congress…

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    ** Director , Medical Affairs Congress Strategy and Execution** The Director , Medical Affairs Congress Strategy and Execution, plays a pivotal role in ... and elevate our overall GMA objectives. **Position Overview** Reporting to the Senior Director of Medical Affairs Excellence & Operations, this role will… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Global Medical Director , Evidence…

    Sanofi Group (Morristown, NJ)
    **Job title** : Global Medical Director , Evidence Generation - Innovation & Partnerships **Location:** Cambridge, MA, Morristown, NJ **About the Job** Sanofi's ... Medical Evidence Generation Lead of the Next-Gen Immunology Franchise, the Medical Director will also be responsible for offering strategic insights and… more
    Sanofi Group (04/23/25)
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  • Senior Claim Director

    Axis (Princeton, NJ)
    claims as well as the related coverage issues ensuring accurate and consistent claims management across impacted underwriting segments and lines of business + ... the selection process. AXIS is seeking a _Senior Claim Director , Specialty Complex_ _Claims_ to join our North America... skills + Experience practicing law as well as claims management (both directly managed and TPA… more
    Axis (04/18/25)
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  • Director , Corporate Strategy, C&V

    Terumo Medical Corporation (Somerset, NJ)
    Director , Corporate Strategy, C&V Date: May 15, 2025 Req ID: 4536 Location: Somerset, NJ, US, 08873 Company: Terumo Americas Holding, Inc. Department: TAH Corporate ... Strategy Terumo Medical Corporation (TMC) develops, manufactures, and markets a complete,...we go next!** **_Advancing healthcare with heart_** **Job Summary** Director , Corporate Strategy - C&V leads multiple critical business… more
    Terumo Medical Corporation (03/19/25)
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  • Director , Global Medical

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    The Director , Global Medical Publications will support Otsuka in leading and developing an overall scientific communication strategy for publications and ... congresses, and will work closely with the Global Medical Affairs Teams, Clinical Teams, Global Value & Real-World Evidence Teams, and Publications Management more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director Specialty…

    Molina Healthcare (New York, NY)
    **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +...claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees… more
    Molina Healthcare (04/11/25)
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  • Associate Director , Commercial Data…

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    …innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health. As ... the Associate Director of Commercial Data Science, Nephrology, you will play...analytical insights translate into actionable business strategies. Exceptional project management , communication skills and ability to deliver high quality… more
    Otsuka America Pharmaceutical Inc. (05/08/25)
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  • Corporate Medical Director

    Humana (Trenton, NJ)
    …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
    Humana (04/24/25)
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  • Director , Global Clinical Development

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Experience with the… more
    Otsuka America Pharmaceutical Inc. (04/03/25)
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  • Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Trenton, NJ)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Complete understanding of… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director (Medicare)

    Molina Healthcare (New York, NY)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (05/02/25)
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  • Life Sciences - Compliance, Risk Management

    Ankura (New York, NY)
    …Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice ... trade association guidance; and international compliance standards governing pharmaceutical and medical device operations. You will be joining a team of industry… more
    Ankura (03/29/25)
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  • Medical Director - Medicare…

    Humana (Trenton, NJ)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (05/14/25)
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