This position is responsible for resolution of escalated issues and audits of daily operations of the HR Shared Services Center. This position serves as back up to HR Shared Services Manager and will maintain confidential employee records on the Workday Human Resources Information System (HRIS). This position will provide HRMS support, customer service to employees, as we

This position is an extended member of the departments leadership team and is responsible for the supervision and the execution of assigned audits and strategic initiatives. These responsibilities include ensuring the appropriateness of the scope, quality and execution of testing and reporting, and the identification as well as tracking of issues to closure. Responsibilit

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

This is a senior level manager position within the Actuarial department. Supporting Level Funded product and additionally supporting Stop Loss products, including all areas of actuarial work pricing, reserving, forecasting, etc Lead internal meetings providing transparency and understanding of the actuarial analyses and results Collect and analyze data to use for actuaria

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

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

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

This position is responsible for actively coordinating and promoting Horizon NJ Health's position and services to community organizations, groups and individuals. The position is responsible for enrolling individuals into HNJH products. In addition, this position will interact with the Health Educators for guidance in the areas of promotions and education Responsibilities

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

The Financial/Accounting Data Analyst Reporting will be assigned to the Finance department and will be responsible for Financial, Planning and Analysis and/or accounting responsibilities. The position will be accountable to support the management leadership team on multiples areas of the budgeting, forecasting and accounting areas. This includes working directly with larg

This position is accountable for supporting Pharmacy clinical management. The responsibilities include assisting in formulary management, medication therapy management, utilization management, research and collaboration with disease management and medical management. Responsibilities Supports the pharmacy formulary management program, medication therapy management program

This position is responsible for performing LPN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care under the direction/supervision of an RN. Performs duties and types of care management as assigned by management. Responsibilities Performs the following job responsibilities under the direc

This position is responsible for helping to identify, secure, and maintain community based housing for MLTSS/SNP/Medicaid Members and for developing, articulating, and implementing a broader housing strategy within the Contractor to expand housing availability/options. The Housing Specialist(s) shall act as the Contractors central housing expert(s)/resource(s), providing

The Mgr, Health & Network Solutions (HNS) Implementation is responsible for leading implementation projects across multiple functional teams while ensuring delivery excellence, driving key business initiatives and solutions across the project while developing standard methodologies to improve efficiencies This individual will manage a team and serve as the primary point o

This position is responsible for managing, monitoring, supporting, and participating in the development/enhancements of distributive system management platforms. Job Description Resolve issues through level 3 in server, operating systems or other software under the control of the Distributed Systems management team Provide guidance to junior infrastructure analysts and fo