HealthcareCrossing Jobs

Commercial Medical Director - Work At Home - USA-KY-Louisville

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-KY-Louisville

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...

Staff Utilization Management Pharmacist (Contract Position) - USA-KY-Louisville

Mon, 26 Jun 2023 00:00:00 CDT

Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. Th...

Provider Contracting Executive - National Transplant Network - USA-KY-Louisville

Fri, 07 Apr 2023 00:00:00 CDT

Job Information Humana Provider Contracting Executive - National Transplant Network in Louisville Kentucky Description The Provider Contracting Executive initiates, negotiates, and executes physician,...

Grievances and Appeals Medical Director - Nationwide - USA-KY-Louisville

Mon, 17 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...

Inpatient Medical Coding Auditor - USA-KY-Louisville

Thu, 20 Apr 2023 00:00:00 CDT

Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patie...

Medical Director - Claims Management - USA-KY-Louisville

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-KY-Louisville

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-KY-Louisville

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-KY-Louisville

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - South Central - USA-KY-Louisville

Thu, 20 Apr 2023 00:00:00 CDT

Associate VP, Behavioral Strategy - USA-KY-Louisville

Thu, 20 Apr 2023 00:00:00 CDT

Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health a...

Associate Director, Program Integrity - USA-KY-Louisville

Thu, 04 May 2023 00:00:00 CDT

Description Are you looking to join a team where you can be a part of our important mission of supporting the TRICARE healthcare program for our nation's military? Humana Government Business is a top...

Assistant Professor - Term - Exercise Science - R101470 - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Department:

*******

Location: Belknap Campus

Time Type:

Full time

Worker Type:

Regular Term (Fixed Term)

Job Req ID:...

Lead User Interface Designer - USA-KY-Louisville

Fri, 19 May 2023 00:00:00 CDT
Description The Lead User Interface Designer leads the team that designs web page layout and online content, user interface graphics, icons, color schemes, content and infrastructure for new product ...

Echocardiographer / Hospital - USA-KY-Louisville

Sat, 10 Jun 2023 00:00:00 CDT
13 wks- days- 7a-5:30p- rotating wknds & call-RDCS- 2D Echo We can help you achieve your career goals by connecting you to our diverse healthcare clients close to home or in desirable locations ...

Registered Nurse (RN) / Corrections - USA-KY-La Grange

Sat, 10 Jun 2023 00:00:00 CDT
Accountable Healthcare is seeking experienced local or travel LPNs or RNs for Correctional Nursing positions in Kentucky!! 12 hour NIGHT shift available! Give us a ******* ! Acute care exp require...

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...

Medical Director - Kentucky Medicaid - USA-KY-Louisville

Tue, 13 Jun 2023 00:00:00 CDT
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...

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 ...