Clinical Reimbursement Manager; DRG Manager; Mount Sinai Hospital Mount Sinai Health SystemClinical Reimbursement Manager; DRG Manager; Mount Sinai HospitalNew York, NY$79,720–$128,115.52 / yearMount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.
Principal Product Manager - Agentforce Demos Salesforce IncPrincipal Product Manager - Agentforce DemosNew York, NY$172,500–$260,100 / yearProven technical aptitude in system integration, data modeling, and data migration, with specific hands-on experience developing, architecting, and implementing custom, deployable solutions that leverage Agentforce to solve complex business problems. Extensive experience administering and managing high-quality Salesforce environments using modern frameworks and the Lightning Platform, alongside a deep understanding and hands-on expertise with AI-driven technologies like Agentforce.
Billing Coordinator II - Urology NYU Langone HealthBilling Coordinator II - UrologyMineola, NY$66,300–$72,345Full timeCertified Coding Specialist Certification (CCS) or Certified Coding Specialist- Physician-based (CCS-P) or Certified Professional Coder (CPC), Certified Outpatient Coding (COC) preferred. Collaborate with the corporate Revenue Integrity Analysts to understand CPT and ICD-10 guidelines, payer policy and procedure manuals, updates, and CMS publications to ensure practices are compliant with current policies and procedures.
NewAppeals Specialist GeneDX LLCAppeals SpecialistCranbury, NJRemote$31.25–$33.65 / hourGeneDx is at the forefront of transforming healthcare through its industry-leading exome and genome testing and interpretation services, fueled by the world's largest, rare disease data sets. The Appeals Specialist is responsible for reviewing denied claims, identifying root causes, and submitting well-documented appeals to maximize reimbursement for specialized laboratory services.
Billing Services Representative Saint Peter's Healthcare System IncBilling Services RepresentativePiscataway, NJReview outstanding accounts using ATB/queues/payments reports/halt report/electronic billing edits/credit balances. Use technology provided (including hospital information system, contract management system, electronic billing system, payer websites and document imaging system.).
Field Reimbursement Manager Syneos - Commercial - ProdField Reimbursement ManagerManhattan, NY$160,000–$170,000 / yearJoin our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients’ lives around the world. Field Reimbursement Managers will be responsible for understanding the unique market issues of their geography, specifically part B reimbursement, health care delivery models, transitions of care and patient pathways.
Lead Software Engineer - AI Humana IncLead Software Engineer - AINew York, NY$129,300–$177,800 / yearExercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. Clinical and Product Partnership: Collaborate closely with product managers, designers, clinicians, and data stakeholders to understand care delivery workflows and translate them into well-scoped, high-impact AI features.
Director, Clinical Sciences, Oncology ModernaTXDirector, Clinical Sciences, OncologyPrinceton, New JerseyWe are proud to have been recognized as a Science Magazine Top Biopharma Employer, a Fast Company Best Workplace for Innovators, and a Great Place to Work in the U.S. If you want to make a difference and join a team that is changing the future of medicine, we invite you to visit modernatx.com/careers to learn more about our current opportunities. This role is best suited for candidates holding a PhD, PharmD, Masters’ or advanced nursing degree with significant scientific and clinical oncology knowledge, pharmaceutical/biotechnology company experience and a comprehensive knowledge of drug development.
Associate Principal Scientist, Pharmar&D TempusAssociate Principal Scientist, Pharmar&DNew York City, NY$155,000–$200,000 / yearReal World Data Expertise & Technical Oversight: Lead the derivation of complex real-world endpoints using extensive coding, demonstrating deep comprehension of Tempus clinical and molecular data structures and complexity, while also serving as an expert on the methodological nuances and limitations of real-world data. Technical/Scientific Skills: Expert-level proficiency in observational late stage trial data or real-world healthcare data, specifically in designing and implementing complex time-to-event methodologies (survival analysis).
Billing Representative -Full-Time Holy Name Medical CenterBilling Representative -Full-TimeHackensack, NJ$20–$25 / hourFull timeHoly Name is New Jersey's only independent Catholic health system, comprising a 361-bed acute care hospital, a renowned cancer center, a state-of-the-art fitness center, a residential hospice, a prestigious nursing school, and an extensive physician network. Healing at Holy Name goes beyond medicine and technology – it is infused with faith, conviction, compassion, and a commitment to educating the next generation of healthcare professionals through a variety of residency and educational programs.
Medical Director - ENT CVS Health CorpMedical Director - ENTNJ$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Executive Medical Director, Neurology, Clinical Development Katalyst HealthCares & Life Sciences IncExecutive Medical Director, Neurology, Clinical DevelopmentBridgewater, NJThis individual will be the primary point person for medical monitoring and oversight of assigned clinical programs, including monitoring of clinical studies, review and interpretation of clinical trial data, authoring clinical study and regulatory communications and documents, and monitoring of competitor activities and data. Provide medical/clinical expertise to internal (Marketing, Sales, Manufacturing, Market Access, Patient Services, Regulatory Affairs, R&D, and Legal) and external (healthcare professionals, Data Safety Monitoring Boards, patients, advocacy groups, etc.) customers.
Software Engineer II Cohere Health Technologies LLCSoftware Engineer IINYRemote$107,000–$130,000 / yearBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
Sr. Software Engineer, Data Platform Cohere Health Technologies LLCSr. Software Engineer, Data PlatformNYRemote$130,000–$160,000 / yearBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. As a Senior Software Engineer of the data platform team, you'll operate across the end-to-end data lifecycle-from ingestion to transformation to integration-driving solutions that align with architectural best practices, governance needs, and business outcomes.
Customer Support Coach - NORAM Digital Arbitrage IncCustomer Support Coach - NORAMNYRemote$55,000–$77,000 / yearOur Customer Support Team: Join a dynamic, fully remote team of over 60 global Customer Support professionals united by our goal of delivering exceptional customer experiences across live chat, email, and phone. Since our founding in 2012, we''ve become the World''s Best Hotel PMS Solutions Provider and landed on Deloitte''s Technology Fast 500 again in 2024, but we''re just getting started.
Nurse Clinical Documentation Specialist St. Joseph's Healthcare SystemNurse Clinical Documentation SpecialistPaterson, NJMedical school graduate (MD, MBBS) or Registered Nurse (RN) and Certified Clinical Documentation Specialist (CCDS) by the Association of Clinical Documentation Integrity Specialists or Certified Documentation Integrity Practitioner (CDIP) or Certified Coding Specialist (CCS) by the American Health Information Management Association within two years or hire. The combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care".
Senior Actuarial Support Analyst Cohere Health Technologies LLCSenior Actuarial Support AnalystNYRemote$105,000–$115,000 / yearWhat you'll need: 5 years of experience in healthcare analytics, cost containment, or similar roles in the healthcare industry, preferably within a payer, provider, or managed care setting, Proficiency in data analytics and visualization tools, for example SQL, Tableau, Power BI, advanced Excel, Strong understanding of healthcare cost drivers and medical claims data, Demonstrated experience in data cleaning, data analysis and problem-solving skills, Ability to transform complex data into actionable insights and clear, concise reports. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.
NewSenior VP - Population Health HarmonyCares.Senior VP - Population HealthNYThis leader establishes the roadmap, leads a focused portfolio of high-impact clinical programs, and partners with Market Operations, Central Operations, and Medical Leadership to deliver performance across key population health measures. Identify actionable cost drivers and develop interventions for high-risk populations, avoidable acute utilization, care transitions, medication-related risk, chronic disease management, and other significant opportunities.
Medical Director Therapy Cohere Health Technologies LLCMedical Director TherapyNYRemote$210,000–$260,000 / yearBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
NewSenior Manager, Provider Experience and Clinical Transformation Big Health IncSenior Manager, Provider Experience and Clinical TransformationNY$140,000–$160,000 / yearThe Senior Manager, Provider Experience and Clinical Transformation is responsible for driving revenue growth and patient impact by ensuring that health systems, provider groups and other organizations are actively engaged with, understand and have a smooth experience supporting their patients to use Big Health's FDA cleared treatments. In pursuit of our mission, we've pioneered the first at-scale digital therapeutic business model in partnership with some of the most prominent global healthcare organizations, including leading Fortune 500 healthcare companies and Scotland's NHS.