Medical Director Appeals Grievances in Houston, TX for Harris Health System

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Search Results: 290 Jobs

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Patient Registration Coordinator Urgent Care

AdventHealth

Orange City, Florida

NEW!

Patient Registration Coordinator Waterford Lakes

AdventHealth

Orlando, Florida

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Assistant Nurse Manager Intermediate Care Unit

St. Charles Health System

Bend, Oregon

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Psychiatry Residency Program Director

AMN Healthcare

San Angelo, Texas

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Environmental Services Sr. Manager

Foundation Health Partners

Fairbanks, Alaska

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Section Chief of Nephrology at The Yale School of Medicine

AMN Healthcare

New Haven, Connecticut

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RN Supervisor - Family Care Clinic

St. Charles Health System

Prineville, Oregon

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Interventional Pain Management - Physician

Carle Health

Bloomington, Illinois

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Program Manager, Managed Care Operations

UCLA

Los Angeles, California

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Director of Information Systems

Gracelight Community Health

Los Angeles , California

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Critical Care Fellowship Director Opportunity

Baystate Health

Springfield, Massachusetts

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Patient Registration Coordinator Urgent Care

AdventHealth

Wesley Chapel, Florida

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Business Data Analyst

UCLA

Los Angeles, California

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Patient Service Representative

AdventHealth

Denver, Colorado

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Physician - Obstetrics

Gracelight Community Health

Eagle Rock , California

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Patient Registration Coordinator Titusville

AdventHealth

Titusville, Florida

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Staff Physician - Radiology

Penn State Health

Harrisburg, Pennsylvania

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Chief Financial Officer

Gracelight Community Health

Los Angeles , California

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Practice Area Specialist

AdventHealth

Tampa, Florida

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Patient Registration Coordinator Urgent Care

AdventHealth

Port Orange, Florida

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Chief, Division of Basic and Clinical Immunology

University of California, Irvine

Irvine, California

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Medical Director - ACHD Program

Nemours

Wilmington, Delaware

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Financial Counselor

AdventHealth

Palm Coast, Florida

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Quality Surgical Officer

RWJBarnabas Health

Newark , New Jersey

Hal B. Jenson, MD Dean, President, and CEO

Western Michigan University Homer Stryker M.D. School of Medicine

Kalamazoo, Michigan

Medical Director Appeals Grievances

JOB SUMMARYThe Medical Director, Appeals and Grievances provides leadership for Community Health Choice medical management programs. This includes reviewing appeals of adverse determinations, tracking them and providing feedback to Medical Affairs on current overturn trends. In addition will provide clinical input and oversight for Care (Disease) Management, Quality Improvement, Credentialing, and Preventive Health programs. Will work with Provider Relations to maintain and improve relationships with the provider community especially with Value based arrangements. Will perform medical necessity reviews as assigned including reviews with peer-to- peer interactions as needed and other duties as assigned.

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