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This senior developer position works independently to develop, implement, and maintain complex technology solutions. Supports API/micro services/Database AWS/On Cloud Review business requirement documents (BRD) and translate into technical specifications Work from technical specifications to independently develop, modify and maintain complex software products Analyze and
Posted Today
This field based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level of care and services are authorized. Responsibilities Assesses patient's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to members
Posted Today
This field based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level of care and services are authorized. Responsibilities Assesses patient's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to members
Posted Today
This field based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level of care and services are authorized. Responsibilities Assesses patient's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to members
Posted Today
The Business Operations Analyst will play an integral role in collaborating with divisional leadership to provide analytical and financial support to improve operational efficiency and support departmental and divisional growth. This role will act as the connection between process, analysis and action. The Business Operations Analyst will be responsible for partnering wit
Posted Today
This senior position provides technical and managerial leadership to multiple IT functional areas. The individual assigns work, develops and maintains project plan, performs resource management, develops time and cost estimates, monitors budget for area of responsibility and performs HR activities for team members. The individual directs team by setting priorities, coordi
Posted 1 day ago
The incumbent will partner with multiple customers across the Enterprise to provide more complex resolutions to analytics/data problems (i.e. descriptive statics, T testing, etc.) which require a study of situational factors, gathering information from several sources, and will provide reporting/analytic deliverables (i.e. tables, graphs, recommendations, etc.) in a consu
Posted 1 day ago
Horizon Blue Cross Blue Shield of New Jersey
- Wall, NJ / Hopewell, NJ / Newark, NJ
This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate level of care, as well as, planning for the transition to the continuum of care and developing a member centric plan of care. Primary Nurses will outreach to high risk members and will work to engage members in preventative care opportu
Posted 1 day ago
The position is responsible for leading a specific clinical care team in a hands on manner to provide exceptional service to the customer and contain medical claims cost. This is accomplished through active involvement and leading of the day to day operations of a clinical care team and ensuring staff is consistent with Horizon's policies and procedures and are compliant
Posted 2 days ago
Horizon Blue Cross Blue Shield of New Jersey
- Hopewell, NJ / Wall, NJ / Newark, NJ
This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management. Responsibilities Assesses patient's clinical need against established guidelines and/or standards to ensure that the l
Posted 2 days ago
This position supports the Clinical Operations functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators Responsibilities Performs review of service requests for completeness of information, collection and transfer of non clinical data, and acquisition of structured clinical data from physicians/pa
Posted 2 days ago
This position is responsible for analyzing, understanding and translating financial business needs into business/technical requirements with minimal supervision Actively participate in requirements gathering , document reviews and testing to ensure finance needs are met Conducts detailed research Act as the primary / key representative for Finance on Workgroups and Projec
Posted 2 days ago
This position is responsible for performing behavioral health duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management. Responsibilities Assesses patient's behavioral health clinical need against established guidelines and/
Posted 5 days ago
This position supports the Clinical Operations functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators 20 hour work week 2 10 hour shifts on Saturday and Sunday Including Holidays Responsibilities Performs review of service requests for completeness of information, collection and transfer of non
Posted 7 days ago
This position is responsible for performing behavioral health duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management. Wednesday Sunday work schedule 2 00PM 10 00PM shift Responsibilities Assesses patient's behavioral heal
Posted 7 days ago
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