HealthcareCrossing Jobs

Commercial Medical Director - Work At Home - USA-IL-Chicago

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-IL-Chicago

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...

Business Support Coordinator 1 - Medical Records - USA-IL-Chicago

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 ...

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

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-IL-Chicago

Sat, 15 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-IL-Chicago

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-IL-Chicago

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...

Broker Relationship Executive - USA-IL-Chicago

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...

Medical Director - Claims Management - USA-IL-Chicago

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-IL-Chicago

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...

Bilingual Medicaid Inbound Call Center Rep - USA-IL-Chicago

Mon, 24 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...

Grievances and Appeals Medical Director - Weekends Required - USA-IL-Chicago

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - South Central - USA-IL-Chicago

Thu, 20 Apr 2023 00:00:00 CDT

Behavioral Health Medical Director - Tricare - USA-IL-Chicago

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...

Customer Service Representative - USA-IL-Chicago

Sun, 21 May 2023 00:00:00 CDT

Description If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver exceptional experiences to our member...

Pharmacist - Long Term Care - Clinical Intervention (third shift) - USA-IL-

Sat, 27 May 2023 00:00:00 CDT

Job Description ***Location is listed as IL - WORK FROM HOME however the position is open to candidates in all 50 states that currently hold an active license in good standing in their state of reside...

HERO Pharmacy Operations Manager (Military \u0026 Veterans) - Military Veterans - USA-IL-Naperville

Sun, 28 May 2023 00:00:00 CDT

\u003cb\u003eHERO Pharmacy Operations Manager (Military \u0026amp; Veterans)\u003c/b\u003e\u003cbr\u003e \u003cb\u003eJob ID\u003c/b\u003e 1174837BR \u003c...

Bilingual Quality Auditor - USA-IL-Chicago

Sat, 03 Jun 2023 00:00:00 CDT

Job Information Humana Bilingual Quality Auditor in Chicago Illinois Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Ser...

Licensed Practical Nurse (LPN)- Telehealth Clinical Technician (TCT) Float - USA-IL-Decatur

Mon, 05 Jun 2023 00:00:00 CDT

Qualifications \n
\n \n To qualify for this position, applicants must meet all requirements with in 30 days of th...

Lead Director, Strategic Accounts - USA-IL-

Wed, 07 Jun 2023 00:00:00 CDT

Job Description As a Health Plan Sales, Lead Director for the CVS Health Solutions Team, you will serve as the senior level sales director for clients within the Enterprise Health Plan segment area of...