Job Seekers, Welcome to Health Career Center
Search Filters
Use this area to filter your search results. Each filter option allows for multiple selections.
NEW! NEW!
University of Minnesota Physicians
Minneapolis, Minnesota
NEW! NEW!
NEW! NEW!
NEW! NEW!
Atlantic Health System
Bayonne, New Jersey
NEW! NEW!
NEW! NEW!
NEW! NEW!
Geisinger
Wilkes-Barre, Pennsylvania
NEW! NEW!
Benefis Health System
Great Falls, Montana
NEW! NEW!
NEW! NEW!
NEW! NEW!
Radiology Partners
Riverdale, Georgia
NEW! NEW!
Spartanburg Regional Healthcare System
Greer, South Carolina
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
Memorial Sloan Kettering Cancer Center
New York, New York
NEW! NEW!
NEW! NEW!
NEW! NEW!
Spartanburg Regional Healthcare System
Spartanburg, South Carolina
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
Mary Washington Healthcare
Fredericksburg, Virginia
NEW! NEW!
Loading... Please wait.
Medical Director Appeals Grievances
JOB SUMMARYThe Medical Director, Appeals and Grievances provides leadership for Community Health Choice medical management programs. This includes reviewing appeals of adverse determinations, tracking them and providing feedback to Medical Affairs on current overturn trends. In addition will provide clinical input and oversight for Care (Disease) Management, Quality Improvement, Credentialing, and Preventive Health programs. Will work with Provider Relations to maintain and improve relationships with the provider community especially with Value based arrangements. Will perform medical necessity reviews as assigned including reviews with peer-to- peer interactions as needed and other duties as assigned.
Loading. Please wait.