EmploymentCrossing Jobs

Director, National Medicaid Care Management Strategy and Practice - USA-DC-Washington

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...

Medical Director - Part Time - USA-DC-Washington

Mon, 26 Jun 2023 00:00:00 CDT

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 situa...

Staff Utilization Management Pharmacist (Contract Position) - USA-DC-Washington

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...

Grievance and Appeals Representative 2 for IRT- Work at Home/Remote USA - USA-DC-Washington

Thu, 14 Sep 2023 00:00:00 CDT

Description Responsibilities The Grievances & Appeals Representative 2 for IRT will be responsible for assigning cases to associates on team to send to independent entity for 2nd level review. Track...

Utilization Management RN (DME / HH Outpatient) - WAH - USA-DC-Washington

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...

Nurse Auditor 2/RN (Coding and Home Health Field exp a MUST) Work At Home - USA-DC-Washington

Sun, 13 Aug 2023 00:00:00 CDT

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate...

Medical Director - Work at Home - USA-DC-Washington

Wed, 30 Aug 2023 00:00:00 CDT

Manager, Utilization Management Nursing - Medicare / Medicaid - USA-DC-Washington

Sun, 13 Aug 2023 00:00:00 CDT

Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in Washington District Of Columbia Description The Manager, Utilization Management Nursing utilizes clinical nursin...

Senior Enterprise Architect - Experience & Analytics (Remote, Virtual, Home office) - USA-DC-Washington

Tue, 19 Sep 2023 00:00:00 CDT

Job Information Humana Senior Enterprise Architect - Experience & Analytics (Remote, Virtual, Home office) in Washington District Of Columbia Description Do you thrive on working on the cutting edge t...

Engineering Manager Cloud Solutions - Remote - USA-DC-Washington

Thu, 06 Jul 2023 00:00:00 CDT

Job Information Humana Engineering Manager Cloud Solutions - Remote in Washington District Of Columbia Description The Manager, Cloud Solutions Engineering Supports development and execution of cloud ...

Associate VP, Technology Solutions, Pharmacy - USA-DC-Washington

Thu, 06 Jul 2023 00:00:00 CDT

Job Information Humana Associate VP, Technology Solutions, Pharmacy in Washington District Of Columbia Description The Associate Vice President of Technology Solutions acts as a liaison and collaborat...

Senior Learning Facilitation Professional-Remote in US - USA-DC-Washington

Sat, 12 Aug 2023 00:00:00 CDT

Job Information Humana Senior Learning Facilitation Professional-Remote in US in Washington District Of Columbia Description The Senior Learning Facilitation Professional will focus on integration and...

Sr. Cognitive / Machine Learning Professional - TLP (Remote) - USA-DC-Washington

Fri, 04 Aug 2023 00:00:00 CDT

Job Information Humana Sr. Cognitive / Machine Learning Professional - TLP (Remote) in Washington District Of Columbia Description The Senior Cognitive/Machine Learning Professional for Test and Learn...

M&A Integration Technology Lead - USA-DC-Washington

Tue, 29 Aug 2023 00:00:00 CDT

Description The M&A IT integration leader will provide strategic guidance with regards to IT integration efforts to Humana's corporate development team and integration management office (IMO) on all ...

Senior Pre-Authorization Nurse - USA-DC-Washington

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...

Business Support Coordinator 1 - Medical Records - USA-DC-Washington

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 ...

Healthcare Paralegal - USA-DC-Washington

Sun, 27 Aug 2023 00:00:00 CDT

Compensation Base to $70,000 plus bonus and significant well paid overtime and firm benefits Medical and Dental Coverage Paid Time Off 401K w/match Life and AD&D Insurance Savings Accounts Tuition re...

Paralegal Manager - USA-DC-Washington

Sun, 27 Aug 2023 00:00:00 CDT

Washington, DC Paralegal Manager Jobs in Litigation Compensation $120,000 Comprehensive compensation, exceptional benefits, bonus and additional incentives Medical and Dental Coverage Paid Time Of...

Health-Care Transactional Associate Attorney - USA-DC-Washington

Thu, 30 May 2024 00:00:00 CDT

Job Overview: A law firm in Washington, DC, is seeking a healthcare transactional Associate Attorney with 6 years of strong healthcare transactional experience. The ideal candidate should have a st...

Senior Corporate Healthcare Regulatory Associate Attorney - USA-DC-Washington

Thu, 06 Jun 2024 00:00:00 CDT

A law firm in Washington, D.C., is seeking a Senior Corporate Healthcare Regulatory Associate Attorney with 5-7 years of experience focusing on regulatory matters in the healthcare sector.

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