HealthcareCrossing Jobs

Commercial Medical Director - Work At Home - USA-ME-Portland

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...

Associate VP, Technology Solutions, Pharmacy - USA-ME-Portland

Thu, 06 Jul 2023 00:00:00 CDT

Job Information Humana Associate VP, Technology Solutions, Pharmacy in Portland Maine Description The Associate Vice President of Technology Solutions acts as a liaison and collaborates with the busin...

Outpatient Medical Coding Auditor-Remote/Virtual in US - USA-ME-Portland

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Portland Maine Description The Medical Coding Auditor extracts clinical information from a variety of medical records a...

Medical Director - Florida Medicaid - USA-ME-Portland

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Medical Director - Florida Medicaid in Portland Maine Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignme...

Manager, Utilization Management RN - Remote - USA-ME-Portland

Fri, 07 Apr 2023 00:00:00 CDT

Job Information Humana Manager, Utilization Management RN - Remote in Portland Maine Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordinatio...

Quality Improvement Program Lead (National Medicaid Quality) - USA-ME-Portland

Fri, 07 Apr 2023 00:00:00 CDT

Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Portland Maine Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be resp...

Manager, Care Management Social Services-WAH Nationwide - USA-ME-Portland

Fri, 07 Apr 2023 00:00:00 CDT

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

Health Information Management Professional - USA-ME-Portland

Mon, 17 Apr 2023 00:00:00 CDT

Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require ...

Medical Director - Claims Management - USA-ME-Portland

Thu, 20 Apr 2023 00:00:00 CDT

Grievances and Appeals Medical Director - Weekends Required - USA-ME-Portland

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...

Medical Director - South Central - USA-ME-Portland

Thu, 20 Apr 2023 00:00:00 CDT

Telephonic Behavioral Health Care Manager - USA-ME-Portland

Thu, 04 May 2023 00:00:00 CDT

Job Information Humana Telephonic Behavioral Health Care Manager in Portland Maine Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs an...

AVP, Stars and Risk Adjustment National Medical Director - USA-ME-Portland

Mon, 01 May 2023 00:00:00 CDT

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

Enterprise Risk Management Lead-US-Remote - USA-ME-Portland

Thu, 11 May 2023 00:00:00 CDT

Job Information Humana Enterprise Risk Management Lead-US-Remote in Portland Maine Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program ...

Student Dietitian Clinical Placement - USA-ME-Bath

Sun, 07 May 2023 00:00:00 CDT

PURPOSE AND SCOPE:The student intern supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS ...

Social Worker (MSW/LCSW/LMSW-cc)- Part Time - USA-ME-Biddeford

Wed, 10 May 2023 00:00:00 CDT

About this role:As a Social Worker with Fresenius Medical Care, you will provide psychosocial services for our dialysis clinic patients. You will work with the health care team to promote positive ad...

Social Services Director - USA-ME-Kennebunk

Sat, 27 May 2023 00:00:00 CDT

Genesis is the nation's leading provider of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how care is d...

Marketing and Admissions Director - USA-ME-Scarborough

Thu, 01 Jun 2023 00:00:00 CDT

Job Information ******* Marketing and Admissions Director in Scarborough Maine Looking for a change in careers. A great opportunity to work with a great team. This may be the position for you. Ben...

Clinical Physician Assistant - Mental Health - Rumford CBOC - USA-ME-Rumford

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-ME-Portland

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 ...