- Humana (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- …of this Medical Director role are related to Part C Medicare Appeals . This position is primary on the non-regulated appeals team, however the ... ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly… more
- Humana (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- …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
- University of Connecticut (UConn) (Storrs, CT)
- …and faculty services. + Participates in processes related to faculty counseling, faculty grievance , and appeals related to the SON operations. + Promotes ... leading processes and initiatives supporting the SON faculty. In coordination with the Director of Teaching and Learning provides a culture of scholarship within the… more