EmploymentCrossing Jobs

Senior Compliance Professional - Louisville, KY or Work at Home (Central and Eastern Time Zone) - USA-VA-Richmond

Fri, 15 Sep 2023 00:00:00 CDT

Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues wher...

Commercial Medical Director - Work At Home - USA-VA-Glen Allen

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...

Business Support Coordinator 1 - Medical Records - USA-VA-Glen Allen

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 ...

Lead Software Engineer - Data Engineering - USA-VA-Glen Allen

Mon, 26 Jun 2023 00:00:00 CDT

Description The Platform Innovation and Engineering team is seeking a passionate engineer with extensive experience building and driving complex platforms and systems. You enjoy working with a strong...

Interoperability Industry & Government Product Management Lead - USA-VA-Glen Allen

Sat, 22 Apr 2023 00:00:00 CDT

Description Be a part of our Interoperability space - Provide guidance to facilitate interaction with digital services and capabilities that connect people with lifelong well-being. Responsibilities...

Grievances and Appeals Medical Director - Nationwide - USA-VA-Glen Allen

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...

Manager, Compliance - Agent Investigation Unit - USA-VA-Glen Allen

Sat, 22 Apr 2023 00:00:00 CDT

Job Information Humana Manager, Compliance - Agent Investigation Unit in Glen Allen Virginia Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Complia...

DRG Validation Coding Auditor - USA-VA-Glen Allen

Sat, 22 Apr 2023 00:00:00 CDT

Description The DRG Validation 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...

Medical Director - Claims Management - USA-VA-Glen Allen

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - South Central - USA-VA-Glen Allen

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-VA-Glen Allen

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...

Behavioral Health Medical Director - Tricare - USA-VA-Glen Allen

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...

Senior Compliance Professional - Medicaid - USA-VA-Glen Allen

Sat, 13 May 2023 00:00:00 CDT

Job Information Humana Senior Compliance Professional - Medicaid in Glen Allen Virginia Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Com...

Bilingual Manager, Learning Facilitation - USA-VA-Glen Allen

Thu, 18 May 2023 00:00:00 CDT

Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST s...

Correspondence Representative 2 - USA-VA-Glen Allen

Tue, 30 May 2023 00:00:00 CDT

Description The Correspondence Representative 2 performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insuran...

Senior IT Compliance Professional - USA-VA-Richmond

Tue, 30 May 2023 00:00:00 CDT

Description The Senior IT Compliance Professional audits the most complex new and existing information systems applications to ensure that appropriate controls exist, that processing is efficient and...

Bilingual Quality Auditor - USA-VA-Glen Allen

Thu, 01 Jun 2023 00:00:00 CDT

Job Information Humana Bilingual Quality Auditor in Glen Allen Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare ...

Environmental Scientist - USA-VA-Richmond

Mon, 05 Jun 2023 00:00:00 CDT

Job Description\n ******* is currently seeking a Environmental Scientist to join our Richmond office. This is an excellent career opportunity for an enthusiastic and talented individual to join ou...

Inbound Contact Representative 2 - CarePlus - USA-VA-Glen Allen

Tue, 13 Jun 2023 00:00:00 CDT

Description Humana is continuing to grow! The CarePlus Health Plan is offering new Inbound Contacts Representative 2 positions that will have the pleasure of taking inbound calls from our members and...

Regulatory Associate Attorney - USA-VA-Richmond

Tue, 23 Apr 2024 00:00:00 CDT

A law firm in Richmond, VA, is seeking a Regulatory Associate Attorney with 1-3 years of experience. The ideal candidate must be a member of the Virginia State Bar in good standing, possess excelle...