EmploymentCrossing Jobs

Oncology Staff Utilization Management Pharmacist - Full time, Work at Home - USA-NJ-Jersey City

Tue, 08 Aug 2023 00:00:00 CDT

Description The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authoriz...

RN -Utilization Management Nurse (Medicare) - Work at home (Eastern Time zone hours)- Southeast Region (GA/SC) - USA-NJ-Jersey City

Tue, 15 Aug 2023 00:00:00 CDT

Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinat...

Charge Registered Nurse II - USA-NY-Maspeth

Mon, 26 Jun 2023 00:00:00 CDT

Job ID 21000EZOAvailable Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall re...

Patient Care Technician - PCT - USA-NJ-Montclair

Mon, 26 Jun 2023 00:00:00 CDT

Job ID 210004TMAvailable Openings 3Position Specific Information Located in Montclair, NJ Patient care experience strongly preferredPURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values ...

Account Manager - USA-NJ-Jersey City

Mon, 26 Jun 2023 00:00:00 CDT

Description Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the nation's largest full-service pharmacy benefits manager (PBM) specifica...

Medical Director - Part Time - USA-NJ-Jersey City

Mon, 26 Jun 2023 00:00:00 CDT

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situa...

Utilization Management RN (DME / HH Outpatient) - WAH - USA-NJ-Jersey City

Mon, 26 Jun 2023 00:00:00 CDT

Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determin...

Director, Group Market Operations - North - USA-NJ-Jersey City

Mon, 26 Jun 2023 00:00:00 CDT

Description The Director, Group Market Operations partners with the assigned Group Market Presidents on cost of care and profitable growth management, risk management and operations. The Market Opera...

Staff Utilization Management Pharmacist (Contract Position) - USA-NJ-Jersey City

Mon, 26 Jun 2023 00:00:00 CDT

Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. Th...

Nurse Auditor 2/RN (Coding and Home Health Field exp a MUST) Work At Home - USA-NJ-Jersey City

Sun, 13 Aug 2023 00:00:00 CDT

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate...

Medical Director - Work at Home - USA-NJ-Jersey City

Wed, 30 Aug 2023 00:00:00 CDT

Manager, Utilization Management Nursing - Medicare / Medicaid - USA-NJ-Jersey City

Fri, 04 Aug 2023 00:00:00 CDT

Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in Jersey City New Jersey Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ...

Business/Informatics Analyst (1 yr in data programming utilizing or SQL) - USA-NY-New York City

Thu, 29 Jun 2023 00:00:00 CDT

Title: Business/Informatics Analyst Duration: through 6/30/23 with poss 1-yr. extension Location: NYC Remote Job Duties: The subcontractor will work with the NYSTEC team to analyze system specific...

Commercial Transactional and Licensing Attorney - USA-NY-New York City

Sat, 06 Apr 2024 00:00:00 CDT

New York City office of a ******* Top Ranked Law Firm seeks a commercial transactional and licensing attorney with 3 years of life sciences transactions and licensing. The candidate will be drafti...

Senior Pre-Authorization Nurse - USA-NJ-Jersey City

Mon, 11 Sep 2023 00:00:00 CDT

Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to t...

Associate Director, Provider Data Interoperability - USA-NY-New York City

Fri, 25 Aug 2023 00:00:00 CDT

Job Information Humana Associate Director, Provider Data Interoperability in New York New York Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient b...

Associate Director, Provider Data Interoperability - USA-NJ-Livingston

Fri, 25 Aug 2023 00:00:00 CDT

Job Information Humana Associate Director, Provider Data Interoperability in Livingston New Jersey Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficie...

Associate Director, Provider Data Interoperability - USA-NJ-Jersey City

Fri, 25 Aug 2023 00:00:00 CDT

Job Information Humana Associate Director, Provider Data Interoperability in Jersey City New Jersey Description Humana's Provider Data and Medicaid Governance team is committed to effective and effici...

Health Care Associate Attorney - USA-NJ-Florham Park

Mon, 01 Apr 2024 00:00:00 CDT

Job Overview: A law firm is seeking a Health Care Associate Attorney with at least 3 years of relevant corporate contract drafting and negotiation experience. The ideal candidate will have expertis...

FDA Drug/Biologics Regulation Counsel - USA-NY-New York City

Mon, 13 May 2024 00:00:00 CDT

Job Title: FDA Drug/Biologics Regulation Counsel

Location: New York City, NY

Overview: Alaw firm is seeking an experienced FDA Drug/Biologics Regulation Counsel with over 10 years of in...