Healthcare Credentialing Jobs

... We are the future of healthcare and our mission is to ... will help members through their healthcare journey, ensuring they get the ... are: Passionate about transforming our..

Company Name: The Little Clinic Position Type: Employee FLSA Status: Non-Exempt   POSITION SUMMARY: Under the day to day direction of the on-duty Nurse Practitioner/Physician Assistant, the general purpose of the Patient ..

Job Information Humana Senior Clinical Recruiter in Colorado Springs Colorado Description The Senior Clinical Recruiter recruits qualified applicants for staff nurse or other positions requiring registered nurse licensure, licensed practical nurse, ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Colorado Springs Colorado Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..

Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..

Posted: 01-Jun-23 Location: Colorado Springs, Colorado Salary: Open Categories: General Nursing Internal Number: 64557 Welcome to Centura Health:At Centura Health, we're on a mission to heal individuals and uplift communities.  We ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Colorado Springs Colorado Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

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 service should be authorized. All ..

Job Information Humana Network Operations Lead - Behavioral Health/Medicaid in Colorado Springs Colorado Description The Network Operations Lead maintains provider relations to support customer service activities through data integrity management and ..

Job Information Humana Strategy Advisor, Healthcare Strategy in Colorado Springs Colorado ... Colorado Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..

Description The Network Operations Coordinator 3 manages provider data including but not limited to demographics and contract accuracy. Additional Information - How we Value You Benefits starting day 1 of employment ..

Hematologist/Oncologist Locums Job in Colorado Springs, ColoradoDetails/Requirements:--Board Certification required--BLS required--Coverage needed starting as soon as credentialed and ongoing--Full-time, Monday through Friday, 8am-5pm, facility can work around providers availability (2-4 weeks per ..

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 service should be authorized. All ..

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 Director's work ..

Job Information Humana UM Medical Director - Conviva in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..

Job Information Humana Medical Director - Texas in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

Job Information Humana Manager, Credentialing in Colorado Springs Colorado Description ... a team of certification and credentialing professionals that to ensure required ... contract requirements. Work collaboratively with credentialing leaders..

... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... organizations, and able to pass..

... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... Medicaid business partners, including: Contracting, Credentialing, Referral/Authorizations, Claims, Grievance and Appeals, ... a Bachelor's degree in Business,..

... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... organizations, and able to pass..