EmploymentCrossing Jobs

Lead Data Architect - USA-NM-Albuquerque

Sun, 10 Sep 2023 00:00:00 CDT

Description The Lead Data Architect works in all data environments which includes data design, database architecture, metadata and repository creation. The Lead Data Architect works on problems of di...

Commercial Medical Director - Work At Home - USA-NM-Albuquerque

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...

House Supervisor - RN (Full Time - 0.90 FTE) - USA-NM-Rio Rancho

Mon, 26 Jun 2023 00:00:00 CDT

House Supervisor - RN (Full Time - 0.90 FTE) Department: Staffing Location: Rio Rancho, NM START YOUR APPLICATION Job Summary and Scope Provide professional and administrative advice, guidance, analyt...

Medical Director - Florida Medicaid - USA-NM-Albuquerque

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Medical Director - Florida Medicaid in Albuquerque New Mexico Description The Medical Director relies on medical background and reviews health claims. The Medical Director work ...

Compliance Lead - Remote - USA-NM-Albuquerque

Fri, 07 Apr 2023 00:00:00 CDT

Job Information Humana Compliance Lead - Remote in Albuquerque New Mexico Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of di...

Behavioral Health Medical Director - USA-NM-Albuquerque

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-NM-Albuquerque

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-NM-Albuquerque

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-NM-Albuquerque

Sat, 22 Apr 2023 00:00:00 CDT

Job Information Humana Manager, Compliance - Agent Investigation Unit in Albuquerque New Mexico Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Comp...

Medical Director - South Central - USA-NM-Albuquerque

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-NM-Albuquerque

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...

Broker Relationship Executive - USA-NM-Albuquerque

Thu, 20 Apr 2023 00:00:00 CDT

Description Are you passionate about contributing to the well-being of the Medicare population? Are you looking for a role that will let your creative ideas, relationship management and sales ability...

Medical Director - Claims Management - USA-NM-Albuquerque

Thu, 20 Apr 2023 00:00:00 CDT

Grievances and Appeals Medical Director - Weekends Required - USA-NM-Albuquerque

Thu, 20 Apr 2023 00:00:00 CDT

Pharmacy Contracting Professional - USA-NM-Albuquerque

Thu, 20 Apr 2023 00:00:00 CDT

Description CenterWell Pharmacy is seeking a pharmacy contracting professional to solicit and maintain network agreements for all pharmacy lines of business. The pharmacy contracting professional 2 w...

Behavioral Health Medical Director - Tricare - USA-NM-Albuquerque

Fri, 28 Apr 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...

Ambulatory Scheduling Coordinator - Full-time - USA-NM-Rio Rancho

Sat, 13 May 2023 00:00:00 CDT

Ambulatory Scheduling Coordinator - Full-time Department: Primary Care Clinics Location: Rio Rancho, NM START YOUR APPLICATION Job Summary and Scope Coordinate with providers, directors, and other lea...

Senior Manager Medicare Sales - Albuquerque, NM - USA-NM-Albuquerque

Fri, 19 May 2023 00:00:00 CDT

Job Information Humana Senior Manager Medicare Sales - Albuquerque, NM in Albuquerque New Mexico Description Are you passionate about the Medicare population, looking for a role in management with the...

Associate Director, Infrastructure Engineering - USA-NM-Albuquerque

Sun, 18 Jun 2023 00:00:00 CDT

Description The Associate Director, Infrastructure Engineering scope of responsibility includes ensuring the technical foundation for Virtualization, Operating Systems, Security, and support of cloud...

Immigration Associate Attorney - USA-NM-Albuquerque

Mon, 18 Mar 2024 00:00:00 CDT

A law firm in Albuquerque, NM, is seeking an Immigration Associate Attorney with 3-5 years of experience to represent public school districts and other educational institutions in immigration, labo...