HealthcareCrossing Jobs

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 ...

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...

Utilization Management RN (DME / HH Outpatient) - WAH - USA-KY-Louisville

Mon, 26 Jun 2023 00:00:00 CDT

Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determin...

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 ...

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...

HEDIS Senior Data Manager - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Description Humana's Health Quality and Stars organization is seeking a HEDIS Senior Data Manager to deliver quality and value in a fast-paced, dynamic environment. The successful candidate will be s...

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...

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:...

Utilization Management Nurse (LPN) - USA-KY-Louisville

Sat, 10 Jun 2023 00:00:00 CDT
Description The Utilization Management Nurse 1 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determin...

Home Dialysis Registered Nurse (RN) - NO WEEKENDS! - USA-KY-Owensboro

Sat, 10 Jun 2023 00:00:00 CDT
3250 Kidron Valley Way,Owensboro,Kentucky,42303-2398,United States of America We are looking for a self-motivated, organized individual who is passionate about patient care and excited for the oppo...

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...

Data and Reporting Professional II - USA-KY-Louisville

Sun, 18 Jun 2023 00:00:00 CDT
Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scri...

Health Info Mgmt Professional - USA-KY-Louisville

Tue, 13 Jun 2023 00:00:00 CDT
Description The Health Information Management Professional 2 ensures data integrity for claims received. The Health Information Management Professional 2 work assignments are varied and frequently re...

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 ...