HealthcareCrossing Jobs

Commercial Medical Director - Work At Home - USA-AR-Rogers

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...

Director, National Medicaid Care Management Strategy and Practice - USA-AR-Rogers

Mon, 26 Jun 2023 00:00:00 CDT

Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. T...

Head of Primary Care Recruiting, Primary Care Organization - USA-AR-Rogers

Wed, 24 Aug 2022 00:00:00 CDT

Description As the Head of Primary Care Recruiting in Humana's Primary Care Organization, you will be responsible for developing and engaging your team and educating the business around the Talent Ac...

RN Case Manager - Telephonic Nurse 2 - Complex Case Management Program (Remote) - USA-AR-Rogers

Fri, 07 Apr 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...

Manager, Care Management Social Services-WAH Nationwide - USA-AR-Rogers

Fri, 07 Apr 2023 00:00:00 CDT

Job Information Humana Manager, Care Management Social Services-WAH Nationwide in Rogers Arkansas Description Job Description Summary The Manager, Care Management leads teams of social work and social...

Associate Director of Documentation and Inpatient Coding, Payment Integrity - REMOTE US - USA-AR-Rogers

Wed, 06 Apr 2022 00:00:00 CDT

Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fr...

Manager, Fraud and Waste-Remote US - USA-AR-Rogers

Sat, 23 Apr 2022 00:00:00 CDT

Job Information Humana Manager, Fraud and Waste-Remote US in Rogers Arkansas Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Ma...

Manager, Fraud and Waste-Remote US - USA-AR-Bentonville

Sat, 23 Apr 2022 00:00:00 CDT

Job Information Humana Manager, Fraud and Waste-Remote US in Bentonville Arkansas Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. T...

Senior Solutions Architect - USA-AR-Rogers

Sat, 30 Apr 2022 00:00:00 CDT

Description Responsibilities The Senior Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. Tr...

Manager, Medicare Risk Adjustment - Remote - USA-AR-Rogers

Thu, 21 Jul 2022 00:00:00 CDT

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medi...

Manager, Medicare Risk Adjustment - Remote - USA-AR-Bentonville

Thu, 28 Jul 2022 00:00:00 CDT

RN Case Manager - Telephonic Nurse 2 -Compact Licensure Required (Remote) - USA-AR-Rogers

Thu, 21 Jul 2022 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 memb...

Commercial Medical Director - National Team - Work From Home - USA-AR-Rogers

Tue, 02 Aug 2022 00:00:00 CDT

Director, State Public Policy - USA-AR-Rogers

Mon, 24 Oct 2022 00:00:00 CDT

Job Information Humana Director, State Public Policy in Rogers Arkansas Description The Director of State Public Policy role resides in Humana's Corporate Affairs department and is charged primarily w...

Director, Medicaid Strategic Solutions - USA-AR-Rogers

Thu, 03 Nov 2022 00:00:00 CDT

Job Information Humana Director, Medicaid Strategic Solutions in Rogers Arkansas Description Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy & Optimization Orga...

AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership - USA-AR-Rogers

Sun, 18 Dec 2022 00:00:00 CST

Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Rogers Arkansas Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking ...

Behavioral Health Medical Director - USA-AR-Rogers

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...

Cardiology Advanced Practitioner - Mercy Clinic Cardiology Springdale - USA-AR-Rogers

Wed, 01 Feb 2023 00:00:00 CST

Cardiology Advanced Practitioner Opportunity in Springdale, AR!

AVP, Stars and Risk Adjustment National Medical Director - USA-AR-Rogers

Mon, 01 May 2023 00:00:00 CDT

Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Rogers Arkansas Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented ...

Senior Innovation Portfolio Strategy Professional - USA-AR-Rogers

Tue, 13 Jun 2023 00:00:00 CDT

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