HealthcareCrossing Jobs

Utilization Management Coordinator 2 - USA-WV-Charleston

Mon, 21 Mar 2022 00:00:00 CDT

Job Information Humana Utilization Management Coordinator 2 in Charleston West Virginia Description The Administration Coordinator 2 contributes to administration of utilization management. The UM Adm...

Senior Embryologist - USA-WV-Chesapeake

Thu, 24 Mar 2022 00:00:00 CDT

Procreate Fertility Center is seeking a full-time, fully ...

Behavioral Health Lead Medical Director - USA-WV-Charleston

Wed, 06 Apr 2022 00:00:00 CDT

Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member popul...

Director, Informatics - USA-WV-Charleston

Fri, 15 Apr 2022 00:00:00 CDT

Job Information Humana Director, Informatics in Charleston West Virginia Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure...

Senior Accreditation Professional-Remote, US - USA-WV-Charleston

Thu, 26 May 2022 00:00:00 CDT

Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards acros...

RN-Care Manager, Behavioral Health-RN in an eNLC state required-Remote Opportunity - USA-WV-Charleston

Sat, 28 May 2022 00:00:00 CDT

Description The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by ...

Medical Director - East Region - USA-WV-Charleston

Fri, 10 Jun 2022 00:00:00 CDT

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site o...

LPN, Home Health Per Diem - USA-WV-Charleston

Sun, 17 Jul 2022 00:00:00 CDT

Job Information Kindred at Home LPN, Home Health Per Diem in Charleston West Virginia As a Home Health LPN, you will: Provide professional nursing services under the direction of a RN in compliance w...

Physical Therapist Assistant, Home Health Full Time - USA-WV-Charleston

Sun, 17 Jul 2022 00:00:00 CDT

Job Information Kindred at Home Physical Therapist Assistant, Home Health Full Time in Charleston West Virginia As a Home Health Physical Therapist Assistant , you will: Administer the physical thera...

Manager, Medicare Risk Adjustment - Remote - USA-WV-Charleston

Thu, 21 Jul 2022 00:00:00 CDT

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medi...

Manager, Compliance Nursing - USA-WV-Charleston

Mon, 05 Sep 2022 00:00:00 CDT

Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, w...

Licensed Practical Nurse Home Health Full Time - USA-WV-Charleston

Thu, 01 Sep 2022 00:00:00 CDT

Job Information Centerwell Licensed Practical Nurse Home Health Full Time in Charleston West Virginia As a H ome Health LPN , you will: Provide professional nursing services under the direction of a ...

Supervisor, Care Management Support-Remote, US - USA-WV-Charleston

Fri, 30 Sep 2022 00:00:00 CDT

Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements...

Quality Improvement Coordinator - USA-WV-Charleston

Sun, 13 Nov 2022 00:00:00 CST

Job Information Humana Quality Improvement Coordinator in Charleston West Virginia Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and com...

Behavioral Health Medical Director - USA-WV-Charleston

Fri, 23 Dec 2022 00:00:00 CST

Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive cl...

Director, Clinical Pharmacy - USA-WV-Charleston

Sun, 25 Dec 2022 00:00:00 CST

Description The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and ...

Compliance Nurse - Home Solutions UM - USA-WV-Charleston

Sat, 22 Apr 2023 00:00:00 CDT

Description Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prev...

Senior Pre-Authorization Nurse - USA-WV-Charleston

Mon, 11 Sep 2023 00:00:00 CDT

Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to t...

Assistant Director of Nursing - ADON - RN - USA-WV-Dunbar

Sat, 27 May 2023 00:00:00 CDT

Genesis a leading provider of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how care is delivered by br...

Bilingual Quality Auditor - USA-WV-Charleston

Thu, 01 Jun 2023 00:00:00 CDT

Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medi...