We interpreted District Of Columbia County, DC as District Of Columbia County, DC.
- Humana (Washington, DC)
- …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
- Humana (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- …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
- Somatus (Mclean, VA)
- …+ Oversee new client pre-delegation audits, annual client audits, development of grievance and appeals workflow processes, and other regulatory requirements. + ... well-being + Community engagement opportunities + And more! The Director of Quality, reporting to the AVP of Quality,...Commercial, Medicaid, Medicare, and Special Need Plans (SNPs). The Director , Quality will work closely with Sr. Manager, Audit… more