Medical Director Appeals Grievances in Houston, TX for Harris Health

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Search Results: 274 Jobs

Executive Director, Associate Chief Nursing Officer over Acute Care, Ambulatory, Dialysis and Behavioral Health at Barnes Jewish Hospital

BJC HealthCare

Saint Louis, Missouri

NEW!

Director, Patient Care- Heart & Vascular Service Line at Barnes Jewish Hospital

BJC HealthCare

Saint Louis, Missouri

NEW!

Executive Director, Associate Chief Nursing Officer (ICU, PCU, Nursing Education) at Barnes Jewish Hospital

BJC HealthCare

Saint Louis, Missouri

NEW!

Director, Environmental Services (Academic Campus)

BJC HealthCare

Saint Louis, Missouri

NEW!

Nurse Manager-4th Floor Observation

Harris Health

Houston, Texas

NEW!

Director, Patient Care-Hospice

Duke University Health System

Durham, North Carolina

NEW!

Director, Ambulatory Operations- OB & Neurology Service Line

BJC HealthCare

Saint Louis, Missouri

NEW!

Director, Newborn Intensive Care at St. Louis Children's Hospital

BJC HealthCare

Saint Louis, Missouri

NEW!

Executive Director, Associate Chief Nursing Officer over ED, OR, L&D and Procedural at Barnes Jewish Hospital

BJC HealthCare

Saint Louis, Missouri

NEW!

Director, Cardiac/Vascular Service Line at Memorial Hospital Belleville/Memorial Hospital Shiloh

BJC HealthCare

Belleville, Illinois

NEW!

Director, Cardiology Service Line for BJC Medical Group

BJC HealthCare

Saint Louis, Missouri

NEW!

Director, Operations- Ambulatory Service Line

BJC HealthCare

Saint Louis, Missouri

NEW!

Executive Director

Louisiana State University Health Shreveport

Shreveport, Louisiana

NEW!

Physician, Internal Medicine - Foster City Medical Center

Sutter Health

Foster City, California

NEW!

Medical Director, Adult Congenital Heart Disease

Nemours Children's Health

Orlando, Florida

NEW!

Chief Medical Officer/Patient Care Physician - 50/50 Ratio

Virginia Community Healthcare Association

Hampton Roads/ Tidewater Region, Virginia

NEW!

Penn State Health Lancaster Medical Center VP, CMO

Penn State Health

Lancaster, Pennsylvania

NEW!

System Chief Nuclear Medicine & Molecular Imaging

Northwell Health

New York City Metro Area, New York

NEW!

Director of Provider Practices, Heart and Vascular (Exempt)

Benefis Health System

Great Falls, Montana

NEW!

Manager, EMS & Base Hospital Program

Phoenix Children's

Phoenix, Arizona

NEW!

Physician, Family Medicine Ample Health (Natomas, CA)

Sutter Health

Sacramento, California

System Controller

NKC Health

North Kansas City, Missouri

Patient Access Trainer, AMG Central Scheduling - Full Time, Days - 9am - 5pm - Morristown

Atlantic Health

Morristown, New Jersey

Medical Office Associate I, Full time, 9am - 5pm - AMG Call Center - Morristown

Atlantic Health

Morristown, New Jersey

Director, Cardiac Critical Care

Nemours Children's Health

Orlando, Florida

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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