- Humana (Phoenix, AZ)
- …for our associates, members and providers. As the Resolution Team Operations Director ( Director , Grievance and Appeals ), you will be accountable for the ... The Resolution team handles all complaints for Humana, including formal grievances, appeals , inquiries and disputes. Our mission is to resolve these complaints… more
- Molina Healthcare (Tucson, AZ)
- …**Job Summary** Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and ... dispute/ appeals processing. * Establishes member and non-contracted provider grievance /dispute and appeals policies/procedures and updates annually or as… more
- Humana (Phoenix, AZ)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....member population, or condition type. May also engage in grievance and appeals reviews. May participate on… more
- Humana (Phoenix, AZ)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....member population, or condition type. May also engage in grievance and appeals reviews. May participate on… more
- Humana (Phoenix, AZ)
- …not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy), and reviews for DME, genetic ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- Banner Health (AZ)
- …is not limited to oversight and collaboration with customer service, grievance and appeals , marketing, provider/network support, compliance, project management, ... innovative employment options by offering remote and hybrid work settings. As the Associate Director of Sales for Banner Plans & Networks, you will lead and inspire… more