EmploymentCrossing Jobs

Process Improvement Professional 2/Audit/Data Analysis/Metrics Reporting - HGB - Work at Home -Louisville, KY - USA-KY-Louisville

Sun, 20 Aug 2023 00:00:00 CDT

Description The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process impro...

Commercial Medical Director - Work At Home - USA-KY-Louisville

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...

Robards Breeder Tech - USA-KY-Robards

Mon, 26 Jun 2023 00:00:00 CDT

Job Information Tyson Foods Robards Breeder Tech in Robards Kentucky Successful applicants for this position must be fully vaccinated against COVID-19 as a condition of employment. Vaccine verificatio...

Grievances and Appeals Medical Director - Nationwide - USA-KY-Louisville

Mon, 17 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-KY-Louisville

Mon, 17 Apr 2023 00:00:00 CDT

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

Bilingual Senior Compliance Professional - Agent Investigations Unit (AIU) - USA-KY-Louisville

Sat, 22 Apr 2023 00:00:00 CDT

Description The Bilingual Senior Compliance Professional - Agent Investigations Unit (AIU) ensures compliance with governmental requirements, specifically those governing the sale of Humana plans. Th...

Senior Claims Product Owner - USA-KY-Louisville

Thu, 27 Apr 2023 00:00:00 CDT

Description The Senior Claims Product Owner is responsible for conveying the product vision and roadmap to an Agile delivery team by defining user stories and prioritizing their product backlog. Work...

Medical Director - Claims Management - USA-KY-Louisville

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-KY-Louisville

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-KY-Louisville

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...

Grievances and Appeals Medical Director - Weekends Required - USA-KY-Louisville

Thu, 20 Apr 2023 00:00:00 CDT

Pharmacy Contracting Professional - USA-KY-Louisville

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...

Medical Director - South Central - USA-KY-Louisville

Thu, 20 Apr 2023 00:00:00 CDT

Associate Director, Program Integrity - USA-KY-Louisville

Thu, 04 May 2023 00:00:00 CDT

Description Are you looking to join a team where you can be a part of our important mission of supporting the TRICARE healthcare program for our nation's military? Humana Government Business is a top...

Compliance Lead - Medicaid Business Readiness - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Respons...

Assistant Professor - Term - Exercise Science - R101470 - USA-KY-Louisville

Fri, 23 Jun 2023 00:00:00 CDT

Department:

*******

Location: Belknap Campus

Time Type:

Full time

Worker Type:

Regular Term (Fixed Term)

Job Req ID:...

Lead User Interface Designer - USA-KY-Louisville

Fri, 19 May 2023 00:00:00 CDT
Description The Lead User Interface Designer leads the team that designs web page layout and online content, user interface graphics, icons, color schemes, content and infrastructure for new product ...

Associate Director, Infrastructure Engineering - USA-KY-Louisville

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...

Appeals Nurse - USA-KY-Louisville

Tue, 13 Jun 2023 00:00:00 CDT
Description The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the ap...

Medical Director - Kentucky Medicaid - USA-KY-Louisville

Tue, 13 Jun 2023 00:00:00 CDT
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...