EmploymentCrossing Jobs

Commercial Medical Director - Work At Home - USA-NC-Charlotte

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...

Medical Director - Florida Medicaid - USA-NC-Charlotte

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Medical Director - Florida Medicaid in Charlotte North Carolina Description The Medical Director relies on medical background and reviews health claims. The Medical Director wor...

Sales Manager, Ovation - USA-NC-Charlotte

Thu, 23 Mar 2023 00:00:00 CDT

Ovation Credit Services is now a LendingTree Company! Ovation is a leading provider of credit services with a strong customer service reputation. Ovation utilizes a proprietary software application th...

RN Case Manager - Telephonic Nurse 2 - Complex Case Management Program (Remote) - USA-NC-Charlotte

Fri, 07 Apr 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...

Behavioral Health Medical Director - USA-NC-Charlotte

Fri, 23 Dec 2022 00:00:00 CST

Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive cl...

Medical Director-KY Medicaid - USA-NC-Charlotte

Sun, 25 Dec 2022 00:00:00 CST

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...

Grievances and Appeals Medical Director - Nationwide - USA-NC-Charlotte

Sat, 22 Apr 2023 00:00:00 CDT

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 interp...

Medical Director - Claims Management - USA-NC-Charlotte

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-NC-Charlotte

Thu, 20 Apr 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...

Medical Director - South Central - USA-NC-Charlotte

Thu, 20 Apr 2023 00:00:00 CDT

Grievances and Appeals Medical Director - Weekends Required - USA-NC-Charlotte

Thu, 20 Apr 2023 00:00:00 CDT

Behavioral Health Medical Director - Tricare - USA-NC-Charlotte

Thu, 04 May 2023 00:00:00 CDT

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately comple...

Coordinator UM Administration - USA-NC-Charlotte

Sat, 29 Apr 2023 00:00:00 CDT

Description The UM Administration Coordinator 2 contributes to administration of utilization management. Responsibilities The UM Administration Coordinator 2 provides non-clinical support for the p...

Senior Pre-Authorization Nurse - USA-NC-Charlotte

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...

Provider Engagement Principal - USA-NC-Charlotte

Sat, 13 May 2023 00:00:00 CDT

Description Deliver a simplified Dental Provider Experience by driving digital and technology solutions forward in a cross collaborative and influential manner Identify the solutions and structure ne...

Pre-Authorization Nursing Supervisor - USA-NC-Charlotte

Sat, 13 May 2023 00:00:00 CDT

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward reques...

Home Health Registered Nurse - USA-NC-Charlotte

Sun, 18 Jun 2023 00:00:00 CDT

Job Information Humana Home Health Registered Nurse in Charlotte North Carolina Description Responsibilities As a Home Health Registered Nurse , you will: Provide admission, case management, and fol...

Pre-Litigation Associate Attorney - USA-NC-Charlotte

Thu, 14 Mar 2024 00:00:00 CDT

A law firm is seeking a Pre-Litigation Associate Attorney to join their team in Charlotte, NC. The ideal candidate will be responsible for overseeing medical case management, negotiation of claims,...

Personal Injury Attorney - USA-NC-Charlotte

Tue, 28 May 2024 00:00:00 CDT

A law firm in Charlotte is seeking a Personal Injury Attorney with 5+ years of personal injury practice experience. The candidate will be responsible for managing all non-priority client files, ove...

Workers' Compensation Attorney - USA-NC-Charlotte

Mon, 27 May 2024 00:00:00 CDT

A law firm in Charlotte is seeking a Workers' Compensation Attorney to represent injured plaintiff-employees throughout the various stages of their North Carolina Workers’ Compensation ca...