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...

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

Tue, 15 Aug 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...

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...

OmniCare Clinical Care Product Management Lead - USA-KY-Louisville

Mon, 26 Jun 2023 00:00:00 CDT

Description The Lead Product Manager Conceives of, develops, delivers, and manages products for customer use. The Lead Product Manager works on problems of diverse scope and complexity ranging from m...

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...

Medical Coding Auditor-Remote/Virtual in US - USA-KY-Lexington

Mon, 26 Jun 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 and PCS) to pa...

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...

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...

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 ...

Associate VP, Technology Solutions, Pharmacy - USA-KY-Louisville

Thu, 06 Jul 2023 00:00:00 CDT

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

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...

Physician Strategy Sr. Professional - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Description Humana is seeking a Physician Strategy Sr. Professional to join our growing team. The Physician Strategy professional will be responsible for setting and implementing strategy for interna...

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...

RN, Utilization Management - Behavioral Health - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation...

Utilization Management Nurse: Home Solutions - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Description Full-Time, Remote Telephonic opportunity As a Utilization Management RN working on the Home Solutions team, you will have the opportunity to use your clinical knowledge, communication sk...

Associate Professor (Open Rank)/Director of Digital Dentistry - Prosthodontics - R101382 - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Department:

*******

Location: Health Sciences Center

Time Type:

Full time

Worker Type:

Regular

Job Req ID: R1013...

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 ...

Actuary, Analytics/Forecasting, Individual Dental and Vision - USA-KY-Louisville

Mon, 26 Jun 2023 00:00:00 CDT

Description The Actuary, Analytics/Forecasting will develop the financial forecast for the dental and vision benefits included within Humana's growing Medicare Advantage business, as well as pricing ...

Nurse Paralegal - USA-KY-Louisville

Thu, 28 Dec 2023 00:00:00 CST

Provides consultation, research, and investigation of medical records Provides medical record chronology, summary, and/or analysis Researches medical literature for cases Provides anatomy and pathophy...