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Akron Children's Logo
Staff Nurse
Akron Children's

Akron, Ohio

NEW!
Nemours Logo
Nursing Assistant - 4 East (NIGHTS)
Nemours

Wilmington, Delaware

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Denver Health Logo
RN Registered Nurse (0.9 FTE) - Infusion Services
Denver Health

Denver, Colorado

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MultiCare Health System Logo
LPN
MultiCare Health System

Olympia, Washington

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MultiCare Health System Logo
CT Technologist
MultiCare Health System

Spokane, Washington

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Labcorp Logo
Phlebotomist Float
Labcorp

Knoxville, Tennessee

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LifeStance Health Logo
Psychiatric Nurse Practitioner (PMHNP) in West Chester, PA
LifeStance Health

West Chester, PA

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University of Maryland Medical System Logo
Front Office Coordinator, PRN
University of Maryland Medical System

Easton, Maryland

NEW!
CHRISTUS Health Logo
Manager Information Services - IM Health Plans
CHRISTUS Health

Irving, Texas

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Duke University Health System Logo
Medical Lab Scientist - Central Automated Lab - 2nd Shift
Duke University Health System

Durham, North Carolina

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BJC HealthCare Logo
BMT Oncology Inpatient, Clinical Nurse
BJC HealthCare

Saint Louis, Missouri

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BJC HealthCare Logo
Patient Access Rep I
BJC HealthCare

Saint Louis, Missouri

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AdventHealth Logo
AdventHealth Sebring FL | APRN/PA (APP) Orthopedics copy
AdventHealth

Sebring, Florida

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AdventHealth Logo
Patient Transporter
AdventHealth

Celebration, Florida

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Baylor Scott & White Health Logo
RN Supervisor Pediatric Med Surg Unit
Baylor Scott & White Health

Belton, Texas

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Baylor Scott & White Health Logo
Patient Services Specialist 2
Baylor Scott & White Health

Dallas, Texas

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Vanderbilt Health Logo
Medical Assistant 2 - Pediatric Clinic Float Pool ($5,000 Sign-On Bonus)
Vanderbilt Health

Nashville, Tennessee

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Phoenix Children's Logo
Pharmacy Tech - Evening Shift
Phoenix Children's

Phoenix, Arizona

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Northwest Permanente, Kaiser Permanente Northwest Logo
Primary Care Physician - Locum
Northwest Permanente, Kaiser Permanente Northwest

Portland, Oregon

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Beebe Healthcare Logo
RN / REGISTERED NURSE - OPERATING ROOM
Beebe Healthcare

Lewes, Delaware

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WMCHealth Logo
Central Sterile Technician
WMCHealth

Poughkeepsie, New York

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Pediatrix Medical Group Logo
Neonatologist - Medical Director
Pediatrix Medical Group

Yakima, WA, USA

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Southern California Permanente Medical Group Logo
Anesthesiologist - Orange County
Southern California Permanente Medical Group

Anaheim, California

NEW!
Southern California Permanente Medical Group Logo
Neurologist - Antelope Valley
Southern California Permanente Medical Group

Lancaster, California

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MultiCare Health System Logo
Mental Health Professional
MultiCare Health System

Burien, Washington

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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.


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