HealthcareCrossing Jobs

RN -Utilization Management Nurse (Medicare) - Work at home (Eastern Time zone hours)- Southeast Region (GA/SC) - USA-ME-Portland

Sun, 10 Sep 2023 00:00:00 CDT

Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinat...

Informaticist 2 - USA-ME-Portland

Mon, 26 Jun 2023 00:00:00 CDT

Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work...

RN Case Manager - Telephonic Nurse 2 - Complex Case Management Program (Remote) - USA-ME-Portland

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...

Code Edit Support Team Medical Coding Coordinator 3 - USA-ME-Portland

Fri, 23 Dec 2022 00:00:00 CST

Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to...

Senior UX Research Professional - USA-ME-Portland

Wed, 04 Jan 2023 00:00:00 CST

Description The Senior UX Research Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Senior UX Rese...

Medical Records Retrieval Representative - Maine - USA-ME-Bangor

Tue, 10 Jan 2023 00:00:00 CST

Description The Medical Records Retrieval Representative works with regional providers in Maine and New England to utilize EMR access and other retrieval methods to retrieve member medical records th...

Consumer Experience Professional (Market Research) - USA-ME-Portland

Sat, 15 Apr 2023 00:00:00 CDT

Description Humana's Marketing Organization is seeking a Consumer Experience Professional to join the Market Research Loyalty & Advocacy Insights team. This enterprise team focuses on data analysis a...

Senior Informaticist - Provider Data Analytics (Remote) - USA-ME-Portland

Thu, 20 Apr 2023 00:00:00 CDT

Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obta...

Medicaid Strategic Solutions Lead - Wellness - USA-ME-Portland

Thu, 20 Apr 2023 00:00:00 CDT

Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that maximize customer value to create a diffe...

Senior Pre-Authorization Nurse - USA-ME-Portland

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...

Data Engineer Marketing Platforms - USA-ME-Portland

Sat, 13 May 2023 00:00:00 CDT

Description Humana is a Fortune 60 market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we...

Pre-Authorization Nursing Supervisor - USA-ME-Portland

Sat, 13 May 2023 00:00:00 CDT

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward reques...

Director, Pharmacy Clinical Pipeline - USA-ME-Portland

Thu, 18 May 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...

Bilingual Quality Auditor - USA-ME-Portland

Sat, 03 Jun 2023 00:00:00 CDT

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

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 ...

Associate Director, Pharmacy Trend - USA-ME-Portland

Sun, 18 Jun 2023 00:00:00 CDT

Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understand...

Senior Innovation Portfolio Strategy Professional - USA-ME-Portland

Tue, 13 Jun 2023 00:00:00 CDT

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

Lecturer in Healthcare Sciences (Children s Nurs) - USA-ME-Bangor

Wed, 14 Jun 2023 00:00:00 CDT

Lecturer in Healthcare Sciences (Children’s Nursing) Bangor University - School of Medical & Health Sciences Location: Bangor Salary: £36,333 to £52,841 Grade 7 OR Grade 8 Hours: Full Time, Part Time ...

Lecturer in Healthcare Sciences (Mental Health Nurs) - USA-ME-Bangor

Wed, 14 Jun 2023 00:00:00 CDT

Lecturer in Healthcare Sciences (Mental Health Nursing) Bangor University - School of Medical & Health Sciences Location: Bangor Salary: £36,333 to £52,841 Grade 7 / 8 Hours: Full Time Contract Type: ...

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 ...