HealthcareCrossing Jobs

Commercial Medical Director - Work At Home - USA-KS-Overland Park

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-KS-Overland Park

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-KS-Overland Park

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...

Medical Director - Florida Medicaid - USA-KS-Overland Park

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Medical Director - Florida Medicaid in Overland Park Kansas Description The Medical Director relies on medical background and reviews health claims. The Medical Director work as...

Manager, Utilization Management RN - Remote - USA-KS-Overland Park

Fri, 07 Apr 2023 00:00:00 CDT

Job Information Humana Manager, Utilization Management RN - Remote in Overland Park Kansas Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coord...

Behavioral Health Medical Director - USA-KS-Overland Park

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...

Medical Director-KY Medicaid - USA-KS-Overland Park

Sun, 25 Dec 2022 00:00:00 CST

Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Directo...

Senior Communications and Marketing Professional - USA-KS-Overland Park

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-KS-Overland Park

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-KS-Overland Park

Sat, 22 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...

Bilingual Medicaid Inbound Call Center Rep - USA-KS-Overland Park

Thu, 04 May 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 - Claims Management - USA-KS-Overland Park

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-KS-Overland Park

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-KS-Overland Park

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...

Grievances and Appeals Medical Director - Weekends Required - USA-KS-Overland Park

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - South Central - USA-KS-Overland Park

Thu, 20 Apr 2023 00:00:00 CDT

Behavioral Health Medical Director - Tricare - USA-KS-Overland Park

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-KS-Overland Park

Sun, 28 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...

Nurse (OR) - USA-MO-Kansas City

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-KS-Overland Park

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 ...