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...

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...

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...

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...

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...

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:...

Remote Systems Clinical Pharmacist - USA-KY-Louisville

Sat, 03 Jun 2023 00:00:00 CDT
Description The Remote Systems Clinical Pharmacist will provide excellent customer service to both internal and external customers by developing and maintaining relationships with Account / Clinical ...

Bilingual Quality Auditor - USA-KY-Louisville

Sat, 03 Jun 2023 00:00:00 CDT
Job Information Humana Bilingual Quality Auditor in Louisville Kentucky Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare ...

Epic Inpatient ASAP Analyst - Remote - 2162270 - USA-KY-Louisville

Mon, 05 Jun 2023 00:00:00 CDT
Job Code 2162270 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outc...

Quality Improvement Manager - USA-KY-Louisville

Sat, 10 Jun 2023 00:00:00 CDT
Description The Manager, Quality Improvement implements quality improvement programs for the Kentucky Medicaid line of business. This includes quality compliance and quality improvement activities su...

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...

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...