Managed Care Coordinator Iconma LLCManaged Care CoordinatorHopewell, NJResponsibilities: This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators. Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.
Technical Account Manager RedSail Technologies, LLCTechnical Account ManagerLong Island, NY$85,000–$120,000 / yearActing as the customers trusted operational advisor and primary point of contact for technical and service delivery matters, the Technical Account Manager develops a deep understanding of each customers business, pharmacy operations, systems, and strategic priorities. When escalation is required, engage Engineering, Product, Network Operations, or other internal teams with complete technical context while remaining the customers single point of accountability until resolution is achieved.
Sr. Oncology Sales Specialist- S2 - (Hackensack, NJ) Eisai USSr. Oncology Sales Specialist- S2 - (Hackensack, NJ)Newark, NJExperience working with key laws and regulations impacting the pharmaceutical industry (e.g., PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state transparency and disclosure laws) preferred. Collaborates appropriately with internal cross functional partners including but not limited to Oncology Thought Leader Liaisons, Oncology Field Reimbursement Managers, and other specialty roles to facilitate aligned, coordinated efforts with Customers in a compliant manner.
Board Certified- Orthopedic Surgeon Dane Street, LLCBoard Certified- Orthopedic SurgeonEast Windsor, NJDane Street is a national leader in Independent Medical Examinations (IMEs) and peer review services, trusted by insurance carriers and organizations across the country for objective, high-quality medical evaluations. We are seeking a skilled and board-certified Othopedic Surgery Specialist in New Jersey to join our team for Independent Medical Examinations (IMEs).
P&C Insurance (Personal & Commercial) Transformation Manager Accenture PlcP&C Insurance (Personal & Commercial) Transformation ManagerMorristown, NJAs a Transformation Manager / Senior Manager, you will lead cross-functional teams to reimagine how work gets done, combining deep insurance expertise with advanced analytics and agentic AI and technology solutions to improve client outcomes. We bring together the talent of our approximately 799,000 people with proprietary assets and platforms, deep process and industry expertise, and leading ecosystem relationships to deliver end-to-end solutions and measurable outcomes at scale.
Senior Customer Relations Lead, PSA Collectors Universe, Inc.Senior Customer Relations Lead, PSAJersey City, NJWe grade, authenticate, vault, and sell millions of record-setting collectibles, all while modernizing and digitalizing the process to further our mission of helping collectors pursue their passions. Our services span collectible trading cards, autographs, comic books, coins, video games, event tickets, and memorabilia.
Director of Data Analytics (P&C Insurance, Underwriting, Reinsurance) Church Pension Group Services CorporationDirector of Data Analytics (P&C Insurance, Underwriting, Reinsurance)New York, New YorkThe role owns the end-to-end workflow: mining data, building rate and reserve indications, supporting reinsurance renewals, evaluating capital adequacy, collaborating with consulting actuaries, and presenting to executives. Required Years Experience: 10 For more than 90 years, The Church Insurance Companies (CIC) has focused on providing The Episcopal Church with broad, cost-effective property and casualty coverage, as well as unique risk management strategies and tools.
Clinical Investigator Oscar HealthClinical InvestigatorNew York, NYRemote$75,348–$98,894 / yearBachelor of Science in Nursing (BSN), Associate Degree in Nursing (ADN) with a Bachelor of Science in Health Administration, Clinical Informatics, or a related Medical Science field, or Associate Degree in Nursing (ADN) with 5+ years of specialized clinical audit experience. Work Location: This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia.
Head Of Risk & Insurance Via TransportationHead Of Risk & InsuranceNew York City, NY$200,000–$300,000 / yearPartner with senior leadership on risk strategy, including coverage decisions, alternative risk transfer (captives, self-insured retentions), and how risk and insurance figure into Via's broader operational and financial planning. Stand up the analytics that tell us whether the program is working: monitor loss ratios, claim frequency and severity, cost per mile, and retention thresholds and use them to inform every renewal.
Senior Staff Attorney The HartfordSenior Staff AttorneyNew York, New YorkRemoteAnalyze intricate substantive and procedural legal and factual issues, conduct extensive, well-reasoned legal research, independently develop and present defense strategies on behalf of a variety of clients. • Provide effective and timely communications, information, legal advice and other services to clients and claims partners on legal and factual issues in a technology driven environment.
Customer Service Representative Brighton Health Plan Solutions, LLCCustomer Service RepresentativeNew York, NY$40,560–$47,840 / yearBrighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. The Customer Service Representative assists members, physicians, hospitals, revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals.
Mitigation Project Manager | Metro NY/NJ Paul Davis Restoration of Metro New York / New JerseyMitigation Project Manager | Metro NY/NJCarlstadt, NJ$65,000–$85,000 / yearFull timeYou'll manage customer communication, field operations, documentation, budgets, and claim compliance while ensuring projects move efficiently and customers feel supported. To create opportunities for great people to deliver best-in-class results—and build lasting careers while doing it.
Site Safety Manager GallagherSite Safety ManagerCranford, New JerseyWhether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well.
Senior Claims Adjuster, Specialty LotSolutions, Inc.Senior Claims Adjuster, SpecialtyIselin, NJ$90,000–$150,000 / yearPart timeAs a direct report to the Manager of Specialty Claims, you should possess the ability to handle and manage a wide variety of severity/complex claims with coverage issues as well as coverage litigation within our Professional Liability line of business. Please be aware of job fraud(s) – all correspondence emails regarding your candidacy will come from our Fortegra.com email address.
Machine Adjuster Pactiv Evergreen IncMachine AdjusterElizabeth, NJ$22–$25 / hourPrograms include company and industry training curricula, support for formal education through the Tuition Reimbursement Program (Non-Union), and a Learning Management System that supports and enhances employee skills at all levels of the organization. Novolex is a leading manufacturer of food, beverage, and specialty packaging that supports multiple industries including foodservice, restaurant delivery and carryout, food processing, grocery and retail, and industrial sectors.
Customer Service Representative/ Bilingual (Spanish) Brighton Health Plan Solutions, LLCCustomer Service Representative/ Bilingual (Spanish)New York, NY$45,760–$47,840 / yearBrighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. About The Role The Customer Service Representative, Bilingual, assists members, physicians, hospitals, revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals.
Service Manager BEUMER GroupService ManagerSomerset, NJ$115,000–$125,000 / yearBEUMER Group is an international leader in intralogistics, specializing in conveying, loading, palletising, packaging, sortation, and distribution technology across a wide range of industries, including airports, e-commerce, warehousing & distribution, and bulk material handling. This role runs service delivery and contract performance for assigned customers and partners cross-functionally to meet service-level agreements, improve operational efficiency, and resolve customer issues.
Remote Claims Representative - 11717 Metro Public AdjustmentRemote Claims Representative - 11717New JerseyRemoteMetro Public Adjusting is a leading firm specializing in advocating for property owners navigating insurance claims after storms, water damage, fire, and other property losses. We are seeking an Outside Sales Representative who will generate new business, manage client relationships, and partner with our claims team to deliver exceptional results.
Third Party Liability Claims Specialist Revecore TechnologiesThird Party Liability Claims SpecialistNYMust reside in the United States within one of the states listed below: Alabama, Arkansas, Delaware, Florida, Georgia, Illinois, Iowa, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maine, Michigan, Minnesota, Missouri, Mississippi, North Carolina, Nebraska, New Hampshire, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota (CST Time Zone), Tennessee, Texas (CST Time Zone), Vermont, Virginia, Wisconsin, and West Virginia. Reviews and works liability elective accounts for providers that have requested settlement tracking, keeping in mind the timely filing deadlines.
Private Client Claims Advocacy Leader Marsh & McLennan Companies IncPrivate Client Claims Advocacy LeaderNew York, NY$125,000–$233,000 / yearFrequently communicate key client and Family Office matters/concerns, team updates, market developments and claims trends with PCS field leadership teams (Zone Leaders and Zone Client Advisor Leaders) as well as MMA regions. Directs and interfaces with PCS Operations and EPIC Transformation teams to design and implement contemporary claims technologies, including claims 'use cases' for Risk Services and Solutions data platform.