- Elevance Health (Hanover, MD)
- ** Manager II Grievance/ Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... an accommodation is granted as required by law._ The ** Manager II Grievance/ Appeals ** responsible for management oversight...clinical decisions, pharmacy on pre-service and post service appeals and grievances related to non- clinical and… more
- CareFirst (Baltimore, MD)
- …authorization of services and approved claims. + Prepares retrospective reviews, case appeals , billing coordination, and clinical support. + Manages the analysis ... meet departmental needs. We are looking for an experienced clinical leader in the greater Baltimore metropolitan area who...who is willing and able to work in a hybrid model. The incumbent will be expected to work… more
- CenterWell (Annapolis, MD)
- …to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather required information and ... collaborates with branch and billing staff to determine appropriate response, manages appeals process. + Monitors and responds to all requests related to revenue… more
- Elevance Health (Washington, DC)
- …onboarding and skill development. Please note that per our policy on hybrid /virtual work, candidates not within a reasonable commuting distance from the posting ... programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor...the United States when conducting utilization review or an appeals consideration and cannot be located on a US… more
- Elevance Health (Washington, DC)
- ** Clinical Operations Medical Director** **Carelon MBM** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... interventions. **How you will make an impact:** + Ensures timely completion of clinical case reviews for their board certified specialty. + Makes physician to… more
- Elevance Health (Hanover, MD)
- ** Clinical Operations Associate Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit** **Management/Utilization** **Review** **Virtual:** ... and ensures essential face-to-face onboarding and skill development. The ** Clinical Operations Associate Medical Director** is responsible for supporting the… more