- AmeriHealth Caritas (Philadelphia, PA)
- …of medical management authorizations.; + Research and Investigate member and/or provider appeals and grievance requests, including review of UM/claim denial ... experience in a Managed Care environment + 1 to 3 years' experience in grievance / appeals environment required **The Ideal Person will have:** + Proven experience… more
- Humana (Dover, DE)
- …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 (Dover, DE)
- …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 actively uses their medical background, experience, and judgement...member population, or condition type. May also engage in grievance and appeals reviews. May participate on… more
- Humana (Dover, DE)
- …Some roles include an overview of coding practices and clinical documentation, dispute/ grievance and appeals processes, and outpatient services and equipment, ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...of care received. May also engage in disputes and grievance and appeals reviews. May participate on… more
- University of Delaware (Newark, DE)
- …32E Context of the Job: Under the limited direction of the Senior Director , Employee and Labor Relations, the Employee and Labor Relations Manager, is responsible ... bargaining negotiations. Major Responsibilities: + In collaboration with the Senior Director , assists with the planning, execution, and evaluation of employee and… more