EmploymentCrossing Jobs

UM Administration Coordinator 2 (Work at Home OH, KY, IN) - USA-OH-Cincinnati

Wed, 23 Aug 2023 00:00:00 CDT

Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administ...

RN -Utilization Management Nurse (Medicare) - Work at home (Eastern Time zone hours)- Southeast Region (GA/SC) - USA-OH-Cincinnati

Tue, 15 Aug 2023 00:00:00 CDT

Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinat...

Director, National Medicaid Care Management Strategy and Practice - USA-OH-Cincinnati

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...

Nurse RN - USA-OH-Cincinnati

Mon, 26 Jun 2023 00:00:00 CDT

Job Information Tyson Foods Nurse RN in Cincinnati Ohio Successful applicants for this position must be fully vaccinated against COVID-19 as a condition of employment. Vaccine verification will be req...

Medical Director - Part Time - USA-OH-Cincinnati

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...

Utilization Management RN (DME / HH Outpatient) - WAH - USA-OH-Cincinnati

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...

Grievance and Appeals Representative 2 for IRT- Work at Home/Remote USA - USA-OH-Cincinnati

Wed, 30 Aug 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...

Staff Utilization Management Pharmacist (Contract Position) - USA-OH-Cincinnati

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...

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

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-OH-Cincinnati

Wed, 30 Aug 2023 00:00:00 CDT

Manager, Utilization Management Nursing - Medicare / Medicaid - USA-OH-Cincinnati

Fri, 04 Aug 2023 00:00:00 CDT

Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in Cincinnati Ohio Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to supp...

Senior Enterprise Architect - Experience & Analytics (Remote, Virtual, Home office) - USA-OH-Cincinnati

Tue, 11 Jul 2023 00:00:00 CDT

Job Information Humana Senior Enterprise Architect - Experience & Analytics (Remote, Virtual, Home office) in Cincinnati Ohio Description Do you thrive on working on the cutting edge technology soluti...

Engineering Manager Cloud Solutions - Remote - USA-OH-Cincinnati

Thu, 06 Jul 2023 00:00:00 CDT

Job Information Humana Engineering Manager Cloud Solutions - Remote in Cincinnati Ohio Description The Manager, Cloud Solutions Engineering Supports development and execution of cloud implementation s...

Senior Learning Facilitation Professional-Remote in US - USA-OH-Cincinnati

Sat, 12 Aug 2023 00:00:00 CDT

Job Information Humana Senior Learning Facilitation Professional-Remote in US in Cincinnati Ohio Description The Senior Learning Facilitation Professional will focus on integration and implementation ...

Sr. Cognitive / Machine Learning Professional - TLP (Remote) - USA-OH-Cincinnati

Fri, 04 Aug 2023 00:00:00 CDT

Job Information Humana Sr. Cognitive / Machine Learning Professional - TLP (Remote) in Cincinnati Ohio Description The Senior Cognitive/Machine Learning Professional for Test and Learn Platform develo...

M&A Integration Technology Lead - USA-OH-Cincinnati

Tue, 11 Jul 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 Integration Specialist - Cloud - USA-OH-Cincinnati

Thu, 14 Sep 2023 00:00:00 CDT

Job Information Humana Senior Integration Specialist - Cloud in Cincinnati Ohio Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating...

Senior Pre-Authorization Nurse - USA-OH-Cincinnati

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-OH-Cincinnati

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 ...

Employee Benefits and Executive Compensation Counsel - USA-OH-Cincinnati

Thu, 09 May 2024 00:00:00 CDT

A law firm in Cincinnati is actively seeking a qualified Employee Benefits and Executive Compensation Counsel. The ideal candidate should have significant experience providing advice to businesses ...