Principal Engineer-Software Development Verizon Communications IncPrincipal Engineer-Software DevelopmentBasking Ridge, NJ$120,500–$231,000 / yearYou will mentor technical teams and develop high-quality, robust applications that meet critical business needs within our evolving Customer Experience Platform (CXP) and FiOS Order management platform. In the role of Principal Engineer of Software Development, you will provide technical leadership for the design and implementation of complex, scalable software solutions primarily using Java Spring Boot and React.
Senior Compliance Auditor Montefiore Medical CenterSenior Compliance AuditorBronx, NY$81,600–$102,000 / yearDevelops and conducts documentation, coding and billing curriculum and education classes for 500 + physicians, allied health professionals, and coding and billing associates annually, including: One-on-one education sessions based on audit findings. Safeguards Montefiore Medical Center revenue and reputation, through the following activities: Participates in external government audits, including: NY Office of Medicaid Inspector General (OMIG).
NewClaims Specialist- Liab Crawford & CoClaims Specialist- LiabBerkeley Heights, NJTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Verifies policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves within designed authority, as necessary, during the processing of the claim.
Care Manager (Clinical) [CMA] Guideway Care, Inc.Care Manager (Clinical) [CMA]NYUsing computer applications Making and answering phone calls the majority of the shift Welcoming patients Reviewing patient medical records Coding and filling out insurance forms Scheduling appointments Arranging for hospital admissions and laboratory services Handling correspondence, billing, and bookkeeping Escalating patient concerns or needs to appropriate provider. Essential Functions: (may include, but not limited to): Manage and support patients' healthcare needs via telephonic outreach Conduct and document visits by using several technology platforms and EHRs Monitors adherence to care plans, evaluates effectiveness, monitors patient progress in a timely manner, and facilitates changes as needed.
NewMgr - Multi-Facility CDI - SMNJ Medical Records FAC#1 Saint Michaels Medical CenterMgr - Multi-Facility CDI - SMNJ Medical Records FAC#1Newark, New JerseyFull timeCombining state-of-the-art technology, the latest diagnostic and therapeutic procedures, leading-edge research, and a network of highly qualified physicians, nurses, and allied health professionals, the hospital provides top-quality health care services delivered with compassionate care. Established by the Franciscan Sisters of the Poor in 1867, Saint Michael's Medical Center is a 358-bed regional tertiary-care, teaching, and research center in the heart of Newark's business and educational district and is accredited by The Joint Commission.
Risk Adjustment Expert - Fully Remote MercorRisk Adjustment Expert - Fully RemoteNew York, New YorkRemote5+ years of experience in risk adjustment coding , HCC coding , or Medicare Advantage coding operations , with at least 2 years in a leadership role. Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid , and ACA risk adjustment programs.
CDI Specialist Episcopal Health Services IncCDI SpecialistNYAdditionally, St. Johns is proud to be redesignated as a Baby-Friendly Hospital by Baby-Friendly USA - the accrediting body and national authority for the Baby-Friendly Hospital Initiative (BFHI) in the United States. The hospital is a recipient of the Gold-Plus Get with the Guidelines-Stroke Quality Achievement Award and the Gold-Plus Get with the Guidelines-Heart Failure Quality Achievement Award from the American Heart Association.
DRG Reviewer MachinifyDRG ReviewerNY$90,000–$115,000 / yearAs part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including clinical and coding assessments, of medical records and related documentation in accordance with contract-specific review criteria. Qualifications: Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more required, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more required.
DRG QA and Trainer MachinifyDRG QA and TrainerNY$85,000–$95,000 / yearThis position plays a key role in auditing the work of both new hires and current staff while conducting training to ensure team members are equipped with the knowledge and skills needed to succeed. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise.
Dentist ( Pediatric Experience Required) - Exams Only - Queens PDS Management Services, LLCDentist ( Pediatric Experience Required) - Exams Only - QueensQueens, NY$4,000–$10,000 / hourPart timeWe offer a comprehensive range of services, including:Pediatric DentistryOrthodonticsLaser SurgeryConscious SedationOutpatient CareWe also provide specialized training programs to help you enhance your expertise and grow your career within our innovative organization. PDS Management Services is seeking skilled Pediatric Dentists or General Dentists with Pediatric Experience to provide exceptional oral healthcare to children at our Queens, NY location.
Facility-Fee Emergency Department Medical Coder Sutherland Global Services IncFacility-Fee Emergency Department Medical CoderClifton, NJThe Facility-Fee Emergency Department Medical Coder is responsible for the accurate review, abstraction, and assignment of ICD-10-CM, CPT, HCPCS, facility-specific charging methodologies, and applicable modifiers for Emergency Department (ED) facility encounters. The coder will review clinical documentation, emergency department records, physician documentation, nursing notes, ancillary reports, and charging information to accurately capture facility services rendered during emergency department visits.
Vice President, Quantitative Sciences & Development SK Life Science, Inc.Vice President, Quantitative Sciences & DevelopmentParamus, New Jersey$325,000–$375,000 / yearFull timeOverview: The Vice President, Quantitative Sciences & Developmentprovides strategic, scientific, and operational leadership for the company's Clinical Pharmacology, Pharmacometrics, Toxicology, DMPK, Biostatistics, Statistical Programming, and Clinical Data Management functions across all phases of drug development. This executive is responsible for developing and overseeing execution of integrated quantitative strategies that support efficient translation from non-clinical development, clinical development, regulatory submissions, and evidence generation while ensuring delivery of high-quality, inspection-ready clinical data and statistical analyses.
Executive Medical Director, Neurology, Clinical Development Katalyst Healthcares & Life SciencesExecutive 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.
Revenue Cycle Executive - AI Strategy MercorRevenue Cycle Executive - AI StrategyNew York, New YorkRemoteProvide executive-level oversight and strategic direction for end-to-end revenue cycle operations, including patient access, coding, billing, denials, and collections. Define and monitor enterprise revenue cycle KPIs , including net collection rate, days in A/R, denial rate, cost-to-collect, and cash collections performance.
RCM Analytics Director - AI Tools MercorRCM Analytics Director - AI ToolsNew York, New YorkRemote5+ years of experience in revenue cycle analytics, RCM reporting , or healthcare financial decision-support, with at least 2 years in a leadership role. Lead revenue cycle analytics, reporting, and decision-support functions to drive data-driven performance improvement across RCM operations .
Revenue Cycle Leader - Fully Remote MercorRevenue Cycle Leader - Fully RemoteNew York, New YorkRemote5+ years of experience in revenue cycle analytics, RCM reporting , or healthcare financial decision-support, with at least 2 years in a leadership role. Lead revenue cycle analytics, reporting, and decision-support functions to drive data-driven performance improvement across RCM operations .
Executive Director of Risk Adjustment UnitedHealth Group IncExecutive Director of Risk AdjustmentNew York, NY$134,600–$230,800 / yearThis leader partners closely with provider organizations, clinical leadership, coding teams, and enterprise stakeholders to embed risk capture into clinical workflows while maintaining regulatory compliance and audit readiness. This role ensures accurate, compliant, and sustainable risk capture across employed and contracted provider networks, directly impacting financial performance in value-based arrangements.
VP Quantitative Sciences & Development Astera SearchVP Quantitative Sciences & DevelopmentParamus, New JerseyA well-established, secure and commercially active biopharma is looking to bring on a Vice President, Quantitative Sciences & Development to lead Clinical Pharmacology, Pharmacometrics, Toxicology, DMPK, Biostatistics, Statistical Programming, and Clinical Data Management across all phases of drug development. Build and mentor high-performing teams across Clinical Pharmacology, Biometrics, and Data Management, recruiting and retaining top scientific and operational talent.
Medicaid Risk Adjustment Market Manager CVS Health CorpMedicaid Risk Adjustment Market ManagerNJ$54,300–$145,860 / yearPartner with segment product, sales, network, clinical teams to implement processes aimed at strengthening member and provider engagement of Revenue Integrity programs resulting in improved outcomes. This is a high-visibility role responsible for driving market level engagement, delivering insights, and demonstrating the value of Medicaid risk adjustment performance to senior leaders and market partners.
Senior Developer Sales Technology MetLife IncSenior Developer Sales TechnologyNew York, NY$104,900–$154,950 / yearRecognized on Fortune magazine\''s list of the "World\''s Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. Partner with Product Owners, Functional Analysts, Scrum Leads, Tech Leads, Data and Analytics teams, QA, DevSecOps, vendors, and business stakeholders to translate outcomes into technical stories, designs, estimates, and implementation plans.