RemoteOtterRemoteOtterThe Director of Appeals & Grievances is responsible for leading, organizing, and directing the activities of the Grievance and Appeals Unit, ensuring compliance with Medicare standards and effectively resolving member complaints.
M.T.A
Molina Healthcare is a leading provider of managed healthcare services, dedicated to improving the health of its members through high-quality, cost-effective care. The company focuses on network strategy and development, ensuring compliance with federal, state, and local regulations while aligning with its core values and strategic goals. Molina Healthcare emphasizes the importance of building strong relationships with complex providers, including hospitals and physician groups, to enhance network adequacy and financial performance. With a commitment to value-based care, Molina Healthcare actively engages in contract negotiations and innovative reimbursement models to meet the diverse needs of its members.
Share This Job!
Save This Job!
Jobs from Molina Talent Acquisition:
Care Manager (RN)
Senior Specialist, Member & Community Interventions
Pharmacy Technician, Clinical/MTM Remote Outbound MST/PST
Specialist, Appeals & Grievances
Health Home Care Coordinator
M.T.A
Molina Healthcare is a leading provider of managed healthcare services, dedicated to improving the health of its members through high-quality, cost-effective care. The company focuses on network strategy and development, ensuring compliance with federal, state, and local regulations while aligning with its core values and strategic goals. Molina Healthcare emphasizes the importance of building strong relationships with complex providers, including hospitals and physician groups, to enhance network adequacy and financial performance. With a commitment to value-based care, Molina Healthcare actively engages in contract negotiations and innovative reimbursement models to meet the diverse needs of its members.
Share This Job!
Save This Job!
Jobs from Molina Talent Acquisition:
Care Manager (RN)
Senior Specialist, Member & Community Interventions
Pharmacy Technician, Clinical/MTM Remote Outbound MST/PST
Specialist, Appeals & Grievances
Health Home Care Coordinator
H.A.H.
Humana At Home 1
Join Humana as a Medical Director to review health claims and appeals, providing critical medical oversight in a remote role.
H.H.M.S
HFMS HF Management Services
The QA Auditor will perform internal quality assurance audits to ensure compliance with operational processes and standards.
H.A.H.
Humana At Home 1
Seeking a Corporate Medical Director to oversee Medicare grievances and appeals with a focus on improving consumer experiences.
CGC Group
The VP of Grievance & Appeals leads multi-state operations to ensure compliance and effective management of grievances and appeals.
CGC Group
Join our team as a Grievance & Appeals Specialist, managing member and provider complaints in a remote setting.