Senior Healthcare Analytics Developer (HEDIS & Stars) Contech SystemsSenior Healthcare Analytics Developer (HEDIS & Stars)Pennington, NJRemote$70–$85 / hourThis role is ideal for a hands-on Tableau developer with strong healthcare quality analytics experience who can independently translate complex HEDIS requirements into scalable dashboards, automated reporting solutions, and actionable business insights. We are seeking a highly technical Healthcare Analytics Developer to design, build, and maintain advanced analytics solutions supporting HEDIS and CMS Star Ratings performance initiatives.
Customer Success Manager - Healthcare Risk Adjustment ReveleerCustomer Success Manager - Healthcare Risk AdjustmentNYRemote$100,000–$110,000 / yearEssential Functions: The Customer Success Manager, Risk Adjustment will work to build long-term, strategic, executive-level partnerships with high-revenue, high level of complexity customers specifically within the ACA HHS CMS RADV Initial Validation Audit. Effectively Communicates - Speaks clearly, listens effectively, and responds well to questions; Writes clearly and informatively; Edits work for errors; Varies writing style to meet needs; Able to read and interpret information; Documents are accurate and delivered on time; Uses good judgement when communicating information.
NewRemote Clinical Liaison ( Women's Health) The Fountain Group LLCRemote Clinical Liaison ( Women's Health)Florham Park, NJRemoteServe as a liaison between healthcare providers and internal stakeholders, ensuring effective communication while adhering to company policies and applicable FDA and local health authority requirements. Job Description: The Clinical Liaison acts as a liaison for healthcare providers, supporting the clinical use of implantable contraception for trained clinicians with Nexplanon.
Part -Time Registered Dietitian (75% remote) RD Nutrition ConsultantsPart -Time Registered Dietitian (75% remote)Manhattan, ManhattanRemoteThis role allows flexibility and a balanced blend of in-person and remote work, ensuring our patients receive the best care while our team enjoys a work-life harmony. Conduct comprehensive nutritional assessments on new admissions and quarterly thereafter, with more frequent reviews as needed for high-risk residents.
Registered Dietitian - Part Time (75% remote) RD Nutrition ConsultantsRegistered Dietitian - Part Time (75% remote)Burlington, BurlingtonRemoteRD Nutrition Consultants LLC is a leading Registered Dietitian Nutritionist consulting firm that provides dietitians to healthcare facilities across the United States. This role offers flexibility and a balanced blend of in-person and remote work, allowing our patients to receive high-quality care while supporting a healthy work-life balance for our team.
Account Manager, Healthcare ID.me IncAccount Manager, HealthcareNYRemote$233,125–$300,000 / yearYou will work closely with internal stakeholders-including Product, Onboarding, Value Management Office, Partnerships, Legal, and Solutions Consulting-to ensure customers realize the full value of their partnership with ID.me. ID.me is seeking a high-performing Account Manager to own and deepen relationships with our current and active Healthcare customers, including a wide variety of health systems, hospitals, payers, and public healthcare agencies.
CDI Specialist- Remote Med-Metrix, LLCCDI Specialist- RemoteParsippany-Troy Hills, NJRemoteThe Clinical Documentation Integrity Specialist performs concurrent chart reviews to validate that the clinical documentation in the medical record appropriately describes the patient's severity of illness, complexity of care, and risk of mortality to facilitate appropriate coding. Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
NewNurse Practitioner (Remote, NJ License Required) GalileoNurse Practitioner (Remote, NJ License Required)Trenton, NJRemoteOperating across 50 states, Galileo offers high-touch, data-driven, multi-specialty, longitudinal care to diverse and complex patients—on the phone, in the home, and everywhere in between. Day to day work includes telephonic outreach ("cold calls") and scheduled video/phone visits for patients who have recently been hospitalized and discharged.
Clinical Reviewer (SCA-Remote) Acentra HealthClinical Reviewer (SCA-Remote)NYRemote$28.37–$35 / hourJob Responsibilities: Assures accuracy and timeliness of all applicable review type cases within contract requirements Assesses, evaluates, and addresses daily workload and call queues; adjusts work schedules daily to meet the workload demands of the department In collaboration with Supervisor, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas Maintains current knowledge base related to review processes and clinical practices related to the review processes, functions as the initial resource to nurse reviewers regarding all review process questions and/or concerns Functions as providers' liaison and contact/resource person for provider customer service issues and problem resolution Performs all applicable review types as workload indicates Fosters positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process Attends training and scheduled meetings and for maintenance and use of current/updated information for review Cross trains and perform duties of other contracts to provide a flexible workforce to meet client/customer needs Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Remote Care Manager (LPN/LVN) - New Jersey PharmD Live CorpRemote Care Manager (LPN/LVN) - New JerseyNew Jersey, NJRemoteEngage patients through scheduled telephonic and virtual care encounters Support patients participating in Chronic Care Management (CCM), Transitional Care Management (TCM), and Remote Patient Monitoring (RPM) programs Provide education regarding chronic disease management, medications, preventive care, and wellness goals Review patient-reported concerns and escalate clinical issues according to established protocols Assist with care coordination activities, including referrals, follow-up appointments, and post-discharge outreach Promote patient adherence to prescribed treatment plans and self-management strategies Maintain accurate and timely documentation in accordance with CMS, payer, and organizational requirements Partner with pharmacists, providers, and care team members to improve patient outcomes and engagement Contribute to quality, compliance, and patient satisfaction initiatives. Active New Jersey LPN license in good standing Minimum two (2) years of nursing experience in ambulatory care, primary care, chronic disease management, telehealth, care coordination, or related clinical settings Strong communication, patient engagement, and documentation skills Ability to assess patient needs and identify concerns requiring escalation Proficiency with electronic health records and web-based clinical platforms Ability to work independently while maintaining productivity and quality expectations Dedicated HIPAA-compliant home workspace with reliable internet access.
Sr. Director - Revenue Integrity (Remote) Stanford Health CareSr. Director - Revenue Integrity (Remote)NYRemote$100.03–$132.51 / hourOperating as a key leader within the Mid-Revenue Cycle, the Senior Director partners closely with executive leaders, clinical department chairs, clinical leadership, finance, School of Medicine partners, Supply Chain, Pharmacy, Strategic Pricing and IT teams. This individual is responsible for leading multiple functional teams, managing substantial budgets, developing long-range planning, and ensuring that strategic initiatives align with Stanford Health Care priorities for patient care, teaching, research, and financial stewardship.
NewSenior Market Access Specialist, Data and Analytics (Remote) Nestle SASenior Market Access Specialist, Data and Analytics (Remote)Bridgewater, NJRemote$125,000–$160,000 / yearKey Responsibilities:Data Solution Development:• Design, build, and maintain SQL-based data models and Power BI dashboards that integrate payer claims, EDI 852/867, copay, PAP, and specialty pharmacy data • Develop automated, production-grade reporting solutions that replace manual spreadsheets and accelerate decision cycles • Build self-service analytics products tailored to Market Access leaders, payer account managers, trade managers, and field sales teams • Apply best-in-class data engineering practices (data validation, version control, documentation) to ensure scalability and reliability • Embed AI and Generative AI capabilities (e.g., Microsoft Copilot, Azure OpenAI, natural language query) into dashboards and solutions to enable conversational analytics and faster self-service insight discovery • Prototype and operationalize machine learning models (e.g., abandonment risk, persistence prediction, gross-to-net forecasting) in partnership with IT and data science partners. Market Access Insights & Decision Support:• Analyze payer patient claims data to surface coverage trends, prior auth/step edit impact, prescription abandonment, and net price dynamics • Mine wholesaler EDI 852 (inventory) and EDI 867 (sales-out) data to identify channel trends, demand signals, and inventory health across distribution partners • Translate patient services data (copay utilization, max-out rates, PAP enrollment velocity, specialty pharmacy fill rates and time-to-fill) into actionable insights for patient experience improvement • Partner with Payer Strategy, Trade, Patient Services, and Field Sales to define KPIs and answer the "so what" behind the data • Leverage AI-driven anomaly detection and pattern recognition to proactively flag coverage shifts, channel disruptions, and patient access risks before they impact performance.
Case Manager RN, Compact License (Remote EST & CST) CVS Health CorpCase Manager RN, Compact License (Remote EST & CST)Work At Home-New Jersey, NJRemote$66,575–$142,576 / yearAssesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client's appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
NewSenior Regulatory and Scientific Affairs Specialist (Remote) Nestle SASenior Regulatory and Scientific Affairs Specialist (Remote)Bridgewater, NJRemote$85,000–$110,000 / yearServe as the RSA representative for select NHSc brands by attending project meetings, working with innovation partners on brand innovation and renovation initiatives, and providing overall regulatory guidance for brand activities. Our broad product portfolio includes renowned brands like Garden of Life, Nature''s Bounty, Vital Proteins, Orgain, Nuun, BOOST, Carnation Breakfast Essentials, Peptamen, Compleat Organic Blends, and more.
NewRemote Registered Dietitian or CNS - Flexible Hours, Work from Anywhere Berry StreetRemote Registered Dietitian or CNS - Flexible Hours, Work from AnywhereTrenton, NJRemoteBerry Street empowers independent dietitians to accept insurance and grow thriving private practices by providing comprehensive credentialing, scheduling, referral, and technical support, as well as access to a vibrant, collaborative clinician community. Dietitians working with Berry Street are committed to these pillars of high-quality care: Evidence-based: We provide quality care based on the latest clinical research.
Outpatient Coding Consultant - Remote Datavant LLCOutpatient Coding Consultant - RemoteNYRemote$20–$28 / hourGuided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.
Compliance & Contract Analyst - Remote/Nationwide Signature Performance, Inc.Compliance & Contract Analyst - Remote/NationwideNewark, NJRemoteMiminimum Requirements:- Bachelor's degree in healthcare, business or healthcare administration, regulatory compliance, or related area, from an accredited college or university or advanced degree (Preferred)- 5+ years' experience in healthcare compliance, Privacy, auditing, investigation management, quality, or related experience gained through working in a medical or clinical role.- 5+ years' experience in contract lifecycle management- Comprehensive understanding of state and federal healthcare laws and regulations. Top candidates will be detailed-oriented, well organized, exhibit strong problem-solving and communication skills, work comfortably under pressure, deliver on tight deadlines, possess excellent documentation and report writing skills and have the ability to work independently and as part of a team- Tell us about your experience with Compliance & Contract Analyst.- Are you a team player and a self-motivator?-
Admin/Clerical - Data Analyst Level 1 - Newark, NJ (Remote) Alpha Business SolutionsAdmin/Clerical - Data Analyst Level 1 - Newark, NJ (Remote)Hopewell, NJRemote4. Requests and evaluates Corrective Action Plans for adequacy, works with vendor on required changes, communicates approval of CAP to the vendors, and monitors open Corrective Action Plans. 2. Identifies and implements process improvements targeted to improve operational efficiencies and delivery of customer service.
Remote ERP IT Program Manager GlobalchannelmanagementRemote ERP IT Program ManagerEdison, New JerseyRemoteDUTIES: Responsible for driving execution discipline, coordinating cross-functional activities, managing dependencies, maintaining governance processes, and ensuring leadership has clear visibility into program progress, risks, issues, and decisions. Highly organized and results-oriented Project Manager to support the execution of the Master Data and Organizational Change Management (OCM) workstreams within the Finance Transformation program.
Medical Auditor - Remote Sprinter Health IncMedical Auditor - RemoteNYRemote$33–$36 / hourOur team of clinicians, technologists, and operators have raised over $125M to date from investors like a16z, General Catalyst, GV, and Accel and enjoy multi-year runway. Most of all, you're energized by the chance to make a real difference - ensuring that accurate, ethical coding supports Sprinter Health's mission to deliver care where patients need it most.