- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …Direct and support physician review to ensure timeliness, accuracy and reliability of UM and Appeals reviews\. + Lead and serve on various committees in order to ... Provides clinical leadership and serves as an internal medical...work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability\. + Outstanding… more
- Humana (Nashville, TN)
- …resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
- Humana (Nashville, TN)
- …resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
- The Cigna Group (Franklin, TN)
- …the programs. **Responsibilities and Essential Functions** + Responsible for development of clinical policy, clinical review decisions, appeals , audits, and ... program development, clinical criteria, and provider issues, supported by program clinical leaders + Collaborate with the Analytics team to provide… more
- American Red Cross (TN)
- …in association with other Red Cross networks, throughout the world. When you join our team , you have a direct impact on a meaningful mission, and you can help save ... allyship and a culture of belonging that empowers all team members. Come to learn, grow, and succeed while...and be able to work independently with initiative and lead an assigned area of responsibility with minimal supervision.… more