HealthcareCrossing Jobs

Commercial Medical Director - Work At Home - USA-OH-Cincinnati

Mon, 26 Jun 2023 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 of...

Claims Process & Policy Professional 2 - USA-OH-Cincinnati

Mon, 26 Jun 2023 00:00:00 CDT

Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated repor...

Nurse Auditor 2/RN (Coding and Home Health Field exp a MUST) Work At Home - USA-OH-Cincinnati

Sun, 13 Aug 2023 00:00:00 CDT

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate...

Senior Communications and Marketing Professional - USA-OH-Cincinnati

Fri, 14 Apr 2023 00:00:00 CDT

Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Human...

Grievances and Appeals Medical Director - Nationwide - USA-OH-Cincinnati

Fri, 14 Apr 2023 00:00:00 CDT

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interp...

DRG Validation Coding Auditor - USA-OH-Cincinnati

Mon, 17 Apr 2023 00:00:00 CDT

Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to pa...

Medical Director - Behavioral Health - Tricare - USA-OH-Cincinnati

Thu, 20 Apr 2023 00:00:00 CDT

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situa...

Broker Relationship Executive - USA-OH-Cincinnati

Thu, 20 Apr 2023 00:00:00 CDT

Description Are you passionate about contributing to the well-being of the Medicare population? Are you looking for a role that will let your creative ideas, relationship management and sales ability...

Bilingual Medicaid Inbound Call Center Rep - USA-OH-Cincinnati

Thu, 20 Apr 2023 00:00:00 CDT

Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Med...

Medical Director - South Central - USA-OH-Cincinnati

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Claims Management - USA-OH-Cincinnati

Thu, 20 Apr 2023 00:00:00 CDT

Grievances and Appeals Medical Director - Weekends Required - USA-OH-Cincinnati

Thu, 20 Apr 2023 00:00:00 CDT

Behavioral Health Medical Director - Tricare - USA-OH-Cincinnati

Thu, 04 May 2023 00:00:00 CDT

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately comple...

Bilingual Manager, Learning Facilitation - USA-OH-Cincinnati

Thu, 18 May 2023 00:00:00 CDT

Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST s...

Delivery Driver RX Tech - Back End Full Time - USA-OH-Cincinnati

Sat, 27 May 2023 00:00:00 CDT

Job Description As a Delivery Driver and Pharmacy Technician for Omnicare Pharmacy, you will deliver prescription orders and/or products to customers on a predetermined route and schedule. Delivery dr...

LICENSED PRACTICAL NURSE - USA-OH-Kipling

Tue, 30 May 2023 00:00:00 CDT

Facility: HOME CARE (EAST) Job Description: Promotes health and healing by functioning as a member of the care team to provide optimum care for convalescent, acutely/chronically ill, home care and lon...

Bilingual Quality Auditor - USA-OH-Cincinnati

Sat, 03 Jun 2023 00:00:00 CDT

Job Information Humana Bilingual Quality Auditor in Cincinnati Ohio Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Serv...

Medical Support Assistant (Advanced) - USA-OH-Akron

Mon, 05 Jun 2023 00:00:00 CDT

Qualifications \n
\n \n Applicants pending the completion of educational or certification/licensure requirements ...

Registered Nurse - Informaticist - USA-OH-Cincinnati

Mon, 05 Jun 2023 00:00:00 CDT

Qualifications \n
\n \n Applicants pending the completion of educational or certification/licensure requirements ...

Business Support Coordinator 1 - Medical Records - USA-OH-Cincinnati

Mon, 26 Jun 2023 00:00:00 CDT

Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for ...