HealthcareCrossing Jobs

Senior Compliance Nurse (RN) - WAH FL - USA-FL-Tampa

Mon, 26 Jun 2023 00:00:00 CDT

Description The Senior Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste...

Claims Process & Policy Professional 2 - USA-FL-Tampa

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-FL-Tampa

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 - Behavioral Health - Tricare - USA-FL-Tampa

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...

Medical Director - Claims Management - USA-FL-Tampa

Thu, 20 Apr 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 o...

Bilingual Medicaid Inbound Call Center Rep - USA-FL-Tampa

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...

Broker Relationship Executive - USA-FL-Tampa

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 - South Central - USA-FL-Tampa

Thu, 20 Apr 2023 00:00:00 CDT

Grievances and Appeals Medical Director - Weekends Required - USA-FL-Tampa

Thu, 20 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...

Behavioral Health Medical Director - Tricare - USA-FL-Tampa

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 Consumer Service Operations Representative - USA-FL-Tampa

Mon, 01 May 2023 00:00:00 CDT

Description The Bilingual Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions area. The Bilingual Consumer Service Operations Repres...

Bilingual Manager, Learning Facilitation - USA-FL-Tampa

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...

Customer Service Representative - USA-FL-Tampa

Tue, 23 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...

Bilingual Quality Auditor - USA-FL-Tampa

Sat, 03 Jun 2023 00:00:00 CDT

Job Information Humana Bilingual Quality Auditor in Tampa Florida Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Servic...

Clinical Administrator Coordinator - 2166904I - USA-FL-Tampa

Mon, 05 Jun 2023 00:00:00 CDT

Job Code 2166904I At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of mill...

Clinical Administrator Coordinator - 2166904 - USA-FL-Tampa

Mon, 05 Jun 2023 00:00:00 CDT

Job Code 2166904 At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of milli...

Patient Government Accounting Specialist - USA-FL-Tampa

Mon, 05 Jun 2023 00:00:00 CDT

The Patient Government Accounting Analyst plays a crucial financial role in minimizing bad debt and maximizing revenue to meet ******* Business Excellence goals. RESPONSIBILITIES/ACCOUNTABILITIES:...

Pharmacist - Long Term Care - USA-FL-Tampa

Mon, 05 Jun 2023 00:00:00 CDT

Job Description Omnicare, Inc. is a wholly owned subsidiary of CVS Health Corporation. ******* What We Do Directly, and through our subsidiaries, Omnicare provides a broad array of pharmac...

Nursing Assistant (Multiple Specialties) - USA-FL-Tampa

Mon, 05 Jun 2023 00:00:00 CDT

Qualifications \n
\n \n Basic Requirements:\n

United States Citizenship: Non-citizens...

Business Support Coordinator 1 - Medical Records - USA-FL-Tampa

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 ...