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Emblemhealth jobs - Edison, NJ

Viewing 1 - 10 of 56 jobs

  • Medical Review Specialist

    Emblemhealth - New York City, NY

    Summary of Position Assist Manager and Clinical Reviewer with review of records/special claims received from customer service, claims and other departments. Perform screening and triage of subscriber, member, and provider demographic and...

    1 day ago from MiracleWorkers.com

  • Group Underwriter

    Emblemhealth - New York City, NY

    Summary The Group Underwriter has the authority to approve premium rates for groups with between 51 and 300 eligible contracts. The Group Underwriter can be expected to have responsibility for an average existing business portfolio that...

    2 days ago from Money Jobs

  • Sr. Specialist, Grievance & Appeals

    Emblemhealth - New York City, NY

    •Serves as liaison with EmblemHealth departments, delegated entities, medical groups and network physicians to ensure timely resolution of cases. •Conduct root cause analysis and propose resolution of individual and global issues. Provide...

    4 days ago from Money Jobs

  • Sr. Contract Compliance Specialist

    Emblemhealth - New York City, NY

    Under the direction of the Director, SSP Contract Compliance ensures initial and ongoing compliance with contract requirements by: Assisting in the analysis of government regulations and contract requirements on the department and the...

    4 days ago from Money Jobs

  • Senior Pharmacy Budget and Rebates Specialist

    Emblemhealth - New York City, NY

    • Creates contract pages in InPharmative Rebate System (EmblemHealth’s Pharmacy Rebates Management System) for each Drug Manufacturer for each line of business based on the fully signed Drug Manufacturer contracts. Updates these entries...

    19 days ago from Money Jobs

  • Pharmacy Case Manager (Diabetes)

    Emblemhealth - New York City, NY

    Summary of Position The Pharmacy Case Manager functions as a key clinical role as part of a multidisciplinary team which provides care coordination and case management support to members. Primary responsibility is the provision of...

    4 days ago from MiracleWorkers.com

  • Case Manager, RN (Diabetes)

    Emblemhealth - New York City, NY

    Summary of Position Achieves optimal benefit and results from the comprehensive management of members with chronic and/or catastrophic illness, members who are frail elderly and/or members whose illness is complicated by challenging...

    15 days ago from MiracleWorkers.com

  • Medical Director (Behavioral Health)

    Emblemhealth - New York City, NY

    the quality of clinical behavioral services delivered to EmblemHealth members; and facilitates the integration of ... with Medical Care Management. • Represents EmblemHealth at the Medicaid BH Regional BH Planning Consortiums.

    30+ days ago from MiracleWorkers.com

  • Sr. Business Data Analyst

    Emblemhealth - New York City, NY

    At EmblemHealth, we strive to provide our employees with a meaningful career. We focus on developing your skills and ... of the position, cost and applicable laws and regulations, Emblemhealth may provide work visa sponsorship for certain...

    25 days ago from Money Jobs

  • Technical Specialist

    New York City, NY

    dental and hospital providers, along with vendors and other EmblemHealth departments. Prepares EMC reports on a daily basis. Provides testing and/or help desk support for medical, dental and hospital providers, along with practice...

    25 days ago from

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