Advanced Search
Title
Company
Description

Location:

Newark, NJ

Focus Search:

care connect
grievance and appeals
mhp
claims manager
utilization management
adjudication
in house
cma
relationship manager
tableau
data warehouse
care management
data analyst
disposition
intake
mba
disputes
scanning
filing
data entry
Relevance
  • Last Updated
  • Relevance
  • Urgently Hiring
All Jobs
  • All Jobs
  • Active
Within 25 miles
  • Exact location
  • Within 5 miles
  • Within 10 miles
  • Within 25 miles
  • Within 50 miles
  • Within 75 miles
  • Within 100 miles
  • Within 200 miles
36 Jobs
Appeals Manager UM
Metroplus Health PlanNew York, NY
This includes investigating and resolving Care Connect (CCONT) issues impacting the adjudication of claims.
Appeals Manager UM
MetroPlus Health PlanNew York, NY
This includes investigating and resolving Care Connect (CCONT) issues impacting the adjudication of claims.
jobsearcher.com/articlesUsps Health Benefits Plan 2021 Career
Learn more about this agencyResponsibilitiesThe position serves as Lead Human Resources Specialist for a team responsible for federal employee benefits.
When you arehired, you are immediately eligible to enroll in the USPS Health Benefits Plan with a Postal Service premium contribution.
Appeals Manager UM
Metroplus Health PlanNew York, NY
This includes investigating and resolving Care Connect (CCONT) issues impacting the adjudication of claims.
Appeals Manager UM
MetroPlus Health PlanNew York, NY
This includes investigating and resolving Care Connect (CCONT) issues impacting the adjudication of claims.
Appeals Manager UM
Metroplus Health PlanNew York, NY
This includes investigating and resolving Care Connect (CCONT) issues impacting the adjudication of claims.
Manager of UM Appeals
Metroplus Health PlanNew York, NY
This includes investigating and resolving Care Connect (CCONT) issues impacting the adjudication of claims.
Full-time
jobsearcher.com/blog
How do Good Interviewers Prepare for Interviews?

Just like candidates take the time to research you and your company, you should take the time to prepare for the interview. Preparing for the interview doesn't just reflect well on your employer brand and create a better candidate experience. Preparation also helps prevent bad hiring decisions. Bad hiring decisions are usually a result of poor execution during the hiring process. However, going into an interview fully prepared and ready to evaluate candidates will help avoid bad hires. So, here are 6 interview preparation tips for employers.

Claims Operations Data Analyst
MetroPlus Health PlanNew York, NY
Position Overview The Claims Operations Support Analyst is responsible providing data analytical and reporting to support the daily end-to-end claims process.
UM Director of Operations
MetroPlus Health PlanNew York, NY
In depth knowledge of all aspects of managed care medical management including UM/CM, Grievance and Appeals, medical policy, clinical claims review (professional and facility), and delegated vendor oversight.
Director of Utilization Management
MetroPlus Health PlanNew York, NY
The Director of UM is responsible for collaboratively enhancing MetroPlus' utilization management capabilities and execution through the development of strong management relationships with other areas within, and outside, the Medical Management Department, including but not limited to Customer Services, MedicareOperations, Exchange Operations, Claims, Compliance, MIS, Finance, and Regulatory Affairs.
MetroPlus Health Plan: Medical Director
MetroPlus Health PlanNewark, NJ
Perform medical necessity reviews and appeal reviewsServe as co-chair for Credentialing CommitteeServe as co-chair of the Utilization Management SubcommitteeSupervise retrospective review of claims to identify practice patterns that could be improved to reduce costs and improve case (e.
jobsearcher.com/blog
In-House vs Outsourcing Recruiting: Which is Better?

When looking at in-house vs outsourcing recruiting, it is important to nail down the benefits for each and whether those benefits outweigh the risks that follow.

Manager of UM Appeals
Metroplus Health PlanNew York, NY
This includes investigating and resolving Care Connect (CCONT) issues impacting the adjudication of claims.
Grievance And Appeals Analyst
MetroPlus Health PlanNew York, NY
Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.
ASP Claims Manager
Metroplus Health Plan IncNew York, NY
Position OverviewThe ASP Claims Manager will effectively and efficiently manage the end-to-end medical claims process for multiple lines of business processed in the ASP (in-house) claims department.
Full-time
Director of Utilization Management Appeals
MetroPlus Health PlanNew York, NY
The Director of UM Appeals is responsible for collaboratively enhancing MetroPlus' utilization management capabilities and execution through the development of strong management relationships with other areas within, and outside, the Medical Management Department, including but not limited to Customer Services, Medicare Operations, Exchange Operations, Claims, Compliance, MIS, Finance, and Regulatory Affairs.
Full-time
jobsearcher.com/blog
How to Ask for a Raise at Work

Here we go again; it’s time to talk money. Whether you’re one year in at a new company or approaching year five on the same team, learning how to ask for a raise should be part of your long-term career plan. These conversations are rarely fun (thanks to society, which has conditioned us to believe that money is taboo), but they are necessary if you want to, well, get paid what you’re worth. Trust us, there’s a lot of money on the table for taking. Below, we’ll discuss tips on timing, approach, and follow-up.

Appeals Manager UM
MetroPlus Health PlanYonkers, NY
The Manager of UM Appeals is responsible for managing authorization-related issues from the claims department.

claims appeals jobs Company: metroplus health plan in Newark, NJ

Latest Blog Posts:

jobsearcher.com/blogParalegal Resume Templates, Examples, and TipsA paralegal job is a great stepping stone to a legal career. As an expert in legal research, paralegals must be organized, strong writers, and a team player with others who require the assistance of the paralegal’s work. Sometimes known as legal assistants, paralegals are a critical part of a legal team’s work. Paralegals work across law firms, corporations, nonprofits, and government agencies.
jobsearcher.com/blogTechnology in the Workplace: How to Improve your HR Function with AIIt’s safe to say that the last two years have brought fundamental changes to the way we work and do business. Companies have relied on technology in the workplace to digitize their services and build a remote-friendly infrastructure that could prepare them for the future.
jobsearcher.com/blogHow to Maximize Action Verbs in Your ResumeWriting a resume that stands out takes more than using keywords and savvy formatting. It’s not just about having an impressive list of accomplishments. It’s also about how you position them using action verbs and deliberate word choice. So if you are looking for a way to craft a resume that stands out and gets calls back? Start by sprucing up your resume with captivating action verbs.
jobsearcher.com/blogWhat is Your Desired Job Title?You’ve decided to look for a new job. So now comes the question — what is your desired job title? There are lots of considerations to think through when deciding on the right title for your next role.
jobsearcher.com/blog4 Things to Consider When Building a Global WorkforceThe rise of remote work has given employers a unique chance to rethink how they approach workforce management. This ranges from rethinking the size and design of their office space to updating their tech stack to accommodate different working styles. It has created new opportunities for companies of all sizes to expand their hiring pool and look for top talent on a global scale.  
jobsearcher.com/blogOperations Job Titles for Entry, Mid, and Senior-Level PositionsAn operations team can take on many functions within a business. With wide-ranging responsibilities come wide-ranging job titles. This means that you have to be more vigilant in your job search. On one hand, the perfect job might be hidden under a title you might not expect. Meanwhile, operations titles that you’re used to looking at may mean something different at a given organization depending on their structure. 
jobsearcher.com/blogHow to Automate Your Job SearchThe internet is ripe with career professionals urging you to be aggressive in your networking and application strategies to land a job. But at what expense? Your sanity? Peace of mind? Energy? Free time? When the job search gets overwhelming—as it inevitably will—leverage automation to take the most tedious tasks off your plate. Here are seven ways to do it.