Viewing 1 - 10 of 14 jobs
analysis, design and development. Requires knowledge of medical terminology. Prefers knowledge of health ... industry operations. Special Licenses and Certifications: Valid NJ RN License required Valid NJ State driver's...
Retention experience Requires knowledge of Medicaid and NJ Familycare line of business Requires knowledge of PC's ... software applications. Knowledge of New Jersey Medicaid and NJ Familycare desired. Education: Requires Bachelor's Degree...
of interventions, and to ensure efficient utilization of benefits. Responsibilities: Conducts high-level ... Knowledge: Requires strong knowledge of the standards of practice for case managers. Requires strong knowledge of...
and the effectiveness and efficiency of operations. For Horizon Healthcare Management Only: Oversees development of ... of intranet and internet applications. Requires knowledge of healthcare industry or health insurance industry.
excellent understanding of the principles and concepts of managed care. Requires knowledge of the health insurance ... Requires current unrestricted Medical Doctor (MD) or Doctor of Osteopathy license from the state of New...
standards to ensure that the level of care and length of stay of the patient are medically appropriate for ... principles. Prefers working knowledge of principles of utilization management. Prefers basic knowledge of health...
job family. The candidate will meet with clients (majority of which will be internal, but could be external as well) to ... dimension. Create and maintain comprehensive documentation of methods, processes and programs. Organize and efficiently...
of financial modeling, analysis forecasting and development of provider reimbursement. This includes determining the ... and clinical profiling tools to assess pricing trends of physician reimbursement and utilization, forecasting and...
of Medical Assistance and Health Services (DMAHS) and the Blue Cross Blue Shield Association (BCBSA). This role ... legal and regulatory requirements, including requirements of the Blue Cross Blue Shield Association (BCBSA). Oversees...
Must understand the mechanics of the billing for physical therapy services, possess an understanding of the Medicare rul ... services), workers compensation, Medicare, Motor Vehicle, Horizon Blue Cross/Shield, Aetna, United Health Care and any...
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