HealthcareCrossing Jobs

Director, Software Engineering (Platform Engineering AI/Machine Learning) - USA-KY-Louisville

Fri, 15 Sep 2023 00:00:00 CDT

Description The Director, Software Engineering codes software applications based on business requirements. The Director, Software Engineering requires an in-depth understanding of how organization ca...

Care Manager, Telephonic Nurse (Bilingual English/Spanish)- Work at Home - USA-KY-Louisville

Mon, 04 Sep 2023 00:00:00 CDT

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

Clinical Manager - USA-KY-Winchester

Mon, 26 Jun 2023 00:00:00 CDT

Job ID 21000G6HAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all r...

Inside Sales SWAT Executive - USA-KY-Louisville

Mon, 26 Jun 2023 00:00:00 CDT

Description Get your foot in the door with this Entry-Level Training Ground Inside Sales Executive position! Enjoy a fast paced dynamic environment that offers a variety of responsibilities and assig...

Wellness Challenges -- Senior Product Manager - USA-KY-Louisville

Mon, 26 Jun 2023 00:00:00 CDT

Description The Wellness Challenges Product Manager will play an important role in creating playful yet effective experience that help our consumers achieve and even exceed their wellness goals. He/s...

Associate Director, Problem, Incident and Event Management - USA-KY-Louisville

Mon, 26 Jun 2023 00:00:00 CDT

Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platfor...

Manager, Utilization Management Nursing - Medicare / Medicaid - USA-KY-Louisville

Fri, 04 Aug 2023 00:00:00 CDT

Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in Louisville Kentucky Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to ...

Senior Pre-Authorization Nurse - USA-KY-Louisville

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...

Associate Director, Accreditation - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accred...

HEDIS Senior Data Manager - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Description Humana's Health Quality and Stars organization is seeking a HEDIS Senior Data Manager to deliver quality and value in a fast-paced, dynamic environment. The successful candidate will be s...

Director, Pharmacy Clinical Pipeline - USA-KY-Louisville

Sun, 04 Jun 2023 00:00:00 CDT

Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position w...

Utilization Management Behavioral Health Professional - USA-KY-Paducah

Sat, 03 Jun 2023 00:00:00 CDT

Description Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional to join our team. The Utilization Management (UM) Behavioral Health (BH) Professiona...

Utilization Management Behavioral Health Professional - USA-KY-Ashland

Sat, 03 Jun 2023 00:00:00 CDT

Bilingual Quality Auditor - USA-KY-Louisville

Sat, 03 Jun 2023 00:00:00 CDT

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

Registered Nurse- Care Manager FLOAT Team - USA-KY-Bellevue

Mon, 05 Jun 2023 00:00:00 CDT

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

Quality Improvement Manager - USA-KY-Louisville

Sat, 10 Jun 2023 00:00:00 CDT

Description The Manager, Quality Improvement implements quality improvement programs for the Kentucky Medicaid line of business. This includes quality compliance and quality improvement activities su...

Senior Sales Enablement Product Marketer - USA-KY-Louisville

Tue, 20 Jun 2023 00:00:00 CDT

Job Information Humana Senior Sales Enablement Product Marketer in Louisville Kentucky Description Humana's Primary Care Organization (PCO) is looking for an experienced and passionate Product Markete...

Appeals Nurse - USA-KY-Louisville

Tue, 13 Jun 2023 00:00:00 CDT

Description The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the ap...

Senior Innovation Portfolio Strategy Professional - USA-KY-Louisville

Tue, 13 Jun 2023 00:00:00 CDT

Job Information Humana Senior Innovation Portfolio Strategy Professional in Louisville Kentucky Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation...

Business Support Coordinator 1 - Medical Records - USA-KY-Louisville

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 ...