EmploymentCrossing Jobs

Commercial Medical Director - Work At Home - USA-IA-Davenport

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...

Senior Clinical Recruiter - USA-IA-Davenport

Wed, 24 Aug 2022 00:00:00 CDT

Job Information Humana Senior Clinical Recruiter in Davenport Iowa Description The Senior Clinical Recruiter recruits qualified applicants for staff nurse or other positions requiring registered nurse...

Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home - USA-IA-Davenport

Thu, 18 Aug 2022 00:00:00 CDT

Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Davenport Iowa Description The Senior Process Improvement Professional analyzes, and me...

Medical Director - Central Region - USA-IA-Davenport

Thu, 18 Aug 2022 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 situ...

Medical Director - Florida Medicaid - USA-IA-Davenport

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Medical Director - Florida Medicaid in Davenport Iowa Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignme...

Senior Clinical Fraud and Waste Investigator - RN and Coding Credential required - REMOTE (Anywhere in US) - USA-IA-Davenport

Fri, 07 Apr 2023 00:00:00 CDT

Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Profe...

Medical Director - East Region - USA-IA-Davenport

Sat, 11 Jun 2022 00:00:00 CDT

Commercial Medical Director - National Team - Work From Home - USA-IA-Davenport

Thu, 28 Jul 2022 00:00:00 CDT

Medical Director - Southeast Region - Work from Home - USA-IA-Davenport

Sat, 08 Oct 2022 00:00:00 CDT

Medical Director - Home Health - USA-IA-Davenport

Wed, 05 Oct 2022 00:00:00 CDT

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpre...

Medical Director - Southeast Region - MUST WORK EVERY OTHER WEEKEND - USA-IA-Davenport

Mon, 24 Oct 2022 00:00:00 CDT

Sr. Professional, Medicaid Network Strategy (Remote) - USA-IA-Davenport

Sun, 13 Nov 2022 00:00:00 CST

Description The Senior Professional, Medicaid Network Strategy will be accountable for supporting the development of Humana Healthy Horizon's (Medicaid) network and provider strategy for its growth m...

Medical Director - Southeast Region - USA-IA-Davenport

Sun, 11 Dec 2022 00:00:00 CST

Behavioral Health Medical Director - USA-IA-Davenport

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-IA-Davenport

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-IA-Davenport

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-IA-Davenport

Thu, 20 Apr 2023 00:00:00 CDT

Grievances and Appeals Medical Director - Weekends Required - USA-IA-Davenport

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - South Central - USA-IA-Davenport

Thu, 20 Apr 2023 00:00:00 CDT

Physician-Home Based Primary Care-Recruitment/Relocation Incentive Authorized - USA-IA-Davenport

Mon, 05 Jun 2023 00:00:00 CDT

Qualifications \n
\n \n To qualify for this position, you must meet the basic requirements as well as any additio...