- CenterWell (Phoenix, AZ)
- …and compliance. Manages the Denials Management data analytics, denial and appeal process. The Director , Home Health Grievances & Appeals assists members, ... part of our caring community and help us put health first** The Director Denials Management provides...related field + 10-15 years progressively responsible experience in home health or hospice industry that includes… more
- Molina Healthcare (Chandler, AZ)
- …care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports plan utilization ... corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees… more
- Evolent (Phoenix, AZ)
- …requests and/or relevant health care experience in claims or appeal & grievances is required. + Ability to read, write and speak the English language fluently ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...work collaboratively with other Utilization Management Leaders including our Director may also be available. **What You Will Be… more