HealthcareCrossing Jobs

Care Manager, Telephonic Nurse (Bilingual English/Spanish)- Work at Home - USA-KY-Louisville

Mon, 04 Sep 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...

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...

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....

Director, National Medicaid Care Management Strategy and Practice - USA-KY-Louisville

Mon, 26 Jun 2023 00:00:00 CDT

Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. T...

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...

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...

Utilization Management Behavioral Health Professional - USA-KY-Bowling Green

Fri, 02 Jun 2023 00:00:00 CDT

Description Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional to join our team. The Utilization Management (UM) Behavioral Health (BH) Professiona...

Utilization Management Behavioral Health Professional - USA-KY-Paducah

Sat, 03 Jun 2023 00:00:00 CDT

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 ...

Utilization Management Behavioral Health Professional - USA-KY-Ashland

Sat, 03 Jun 2023 00:00:00 CDT

Utilization Management Behavioral Health Professional - USA-KY-Pikeville

Fri, 02 Jun 2023 00:00:00 CDT

Utilization Management Behavioral Health Professional - USA-KY-Hopkinsville

Fri, 02 Jun 2023 00:00:00 CDT

Utilization Management Behavioral Health Professional - USA-KY-Mayfield

Fri, 02 Jun 2023 00:00:00 CDT

Utilization Management Behavioral Health Professional - USA-KY-Owensboro

Fri, 02 Jun 2023 00:00:00 CDT

Utilization Management Behavioral Health Professional - USA-KY-Maysville

Sat, 03 Jun 2023 00:00:00 CDT

Registered Nurse- Care Manager FLOAT Team - USA-KY-Bellevue

Mon, 05 Jun 2023 00:00:00 CDT

Qualifications \n
\n \n Applicants pending the completion of educational or certification/licensure requirements ...

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...

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...