Displaying 46 - 60 of 77 Jobs.
Call Center Service Associate (Omnia)
Hopewell, NJ
Provide excellent service to customers through the resolution of basic customer inquiries received by phone or though written correspondence. Responsibilities Receive customer inquiries...
Hopewell, NJ
Provide excellent service to customers through the resolution of basic customer inquiries received by phone or though written correspondence. Responsibilities Receive customer inquiries...
Clinical Analyst Analyst III
Newark, NJ
The role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out clinical analytics. The position is a key team member collaborating in a m...
Newark, NJ
The role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out clinical analytics. The position is a key team member collaborating in a m...
Auditor II
Newark, NJ
Reporting directly to an Audit Manager, responsibilities include developing the scope of audits, programs or initiatives, executing testing and reporting in a quality manner, and the ide...
Newark, NJ
Reporting directly to an Audit Manager, responsibilities include developing the scope of audits, programs or initiatives, executing testing and reporting in a quality manner, and the ide...
Pharmacy Specialist II
Hopewell, NJ; Wall, NJ
This position is responsible for receiving verbal and written request for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting...
Hopewell, NJ; Wall, NJ
This position is responsible for receiving verbal and written request for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting...
RN II
Hopewell, NJ
This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Pe...
Hopewell, NJ
This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Pe...
Mgr, Regulatory Compliance
Newark, NJ
The Mgr, Regulatory Compliance is responsible for the daily oversight and management of compliance activities across the assigned Horizon Line of Business (LOB). This position ensures th...
Newark, NJ
The Mgr, Regulatory Compliance is responsible for the daily oversight and management of compliance activities across the assigned Horizon Line of Business (LOB). This position ensures th...
Workforce Mgmt Analyst
Hopewell, NJ; Newark, NJ
Responsible for all workforce functions including budgeting, capacity planning, forecasting, scheduling and real time monitoring. Own and manage creation of leveryday tactical workload f...
Hopewell, NJ; Newark, NJ
Responsible for all workforce functions including budgeting, capacity planning, forecasting, scheduling and real time monitoring. Own and manage creation of leveryday tactical workload f...
Medical Economics Consultant-7
Newark, NJ
The Medical Economics Consultant provides support and consultation to the Medical Economics team through analyzing key business issues related to cost, utilization and revenue for all pr...
Newark, NJ
The Medical Economics Consultant provides support and consultation to the Medical Economics team through analyzing key business issues related to cost, utilization and revenue for all pr...
Clinical Risk Adjustment Management RN
Newark, NJ
This position will perform care management duties specifically targeting high risk members within Medicare Advantage/Commercial risk adjusted populations to enhance the deployment of ris...
Newark, NJ
This position will perform care management duties specifically targeting high risk members within Medicare Advantage/Commercial risk adjusted populations to enhance the deployment of ris...
Risk Adjustment Operations Coordinator
Newark, NJ
This position is accountable for the development and execution of on going risk adjustment educational communications for the enterprise. The Program Communication Specialist will partic...
Newark, NJ
This position is accountable for the development and execution of on going risk adjustment educational communications for the enterprise. The Program Communication Specialist will partic...
Medical Economics Analyst
Newark, NJ
The position is primarily responsible for driving and producing various financial reporting and analytical activities that support Healthcare Management's P&L evaluation on routine basis...
Newark, NJ
The position is primarily responsible for driving and producing various financial reporting and analytical activities that support Healthcare Management's P&L evaluation on routine basis...
ASO Accountant I
Newark, NJ
The ASO Accountant I is responsible for the preparation, analysis, and completion of Minimum Premium and Self Insured invoices. This also includes compiling claims and traditional bills...
Newark, NJ
The ASO Accountant I is responsible for the preparation, analysis, and completion of Minimum Premium and Self Insured invoices. This also includes compiling claims and traditional bills...
RN II, Primary Nurse Care
Wall, NJ; Hopewell, NJ; Newark, NJ
This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate level of care, as well as, planning for the tran...
Wall, NJ; Hopewell, NJ; Newark, NJ
This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate level of care, as well as, planning for the tran...
HEDIS Quality Auditor II RN
Newark, NJ; Wall, NJ; Hopewell, NJ
Responsible for conducting file audits for all areas of clinical operations. These audits review daily business practice compliance to regulatory compliance relative to NCQA, URAC and CM...
Newark, NJ; Wall, NJ; Hopewell, NJ
Responsible for conducting file audits for all areas of clinical operations. These audits review daily business practice compliance to regulatory compliance relative to NCQA, URAC and CM...
Group Underwriter II
Newark, NJ
This position provides Rating & Underwriting services and support to the Sales team and is responsible for the production of rates for the 51+ markets. This position will support Rating...
Newark, NJ
This position provides Rating & Underwriting services and support to the Sales team and is responsible for the production of rates for the 51+ markets. This position will support Rating...