HealthcareCrossing Jobs

Lead Solutions Architect - Cloud (Remote) - USA-KY-Louisville

Fri, 15 Sep 2023 00:00:00 CDT

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

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...

Clinical Manager - USA-KY-Winchester

Mon, 26 Jun 2023 00:00:00 CDT

Job ID 21000G6HAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all r...

Patient Care Technician - PCT - USA-KY-Frankfort

Mon, 26 Jun 2023 00:00:00 CDT

Job ID 21000G9RAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all ...

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...

Outpatient Registered Nurse - RN - USA-KY-Mayfield

Mon, 26 Jun 2023 00:00:00 CDT

Job ID 21000GHGAvailable Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses....

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...

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...

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...

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:...

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...

Clinical Assistant Professor of Higher Education - R101533 - 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:...

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...

Senior Innovation Portfolio Strategy Professional - USA-KY-Louisville

Tue, 13 Jun 2023 00:00:00 CDT
Job Information Humana Senior Innovation Portfolio Strategy Professional in Louisville Kentucky Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation...

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 ...

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...