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PIH Health Logo
Department Supervisor, LDRP, Full Time, Nights
PIH Health

Los Angeles, California

NEW!
Nemours Logo
Director, Cardiac Critical Care
Nemours

Orlando, Florida

NEW!
Benefis Health System Logo
Director of Provider Practices, Heart and Vascular Institute (Exempt)
Benefis Health System

Great Falls, Montana

NEW!
Nicklaus Children’s Health System Logo
Payer Credentialing Representative
Nicklaus Children’s Health System

Miami, Florida

NEW!
Nemours Logo
Director, Cardiac Anesthesia
Nemours

Orlando, Florida

NEW!
PIH Health Logo
Department Supervisor, NICU, Full Time, Nights
PIH Health

Los Angeles, California

NEW!
PIH Health Logo
Department Supervisor, CVDOU, Full Time, Days
PIH Health

Los Angeles, California

NEW!
WMCHealth Logo
Practice Administrator
WMCHealth

West Nyack, New York

NEW!
WMCHealth Logo
Director of Patient Accounts
WMCHealth

Valhalla, New York

NEW!
WMCHealth Logo
Office Manager
WMCHealth

Poughkeepsie, New York

NEW!
Northeast Georgia Health System Logo
Director Invasive Cardiology Services
Northeast Georgia Health System

Gainesville, Georgia

NEW!
BJC HealthCare Logo
Solutions Architect
BJC HealthCare

Saint Louis, Missouri

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AdventHealth Logo
Patient Registration Coordinator Urgent Care
AdventHealth

Shawnee Mission, Kansas

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AdventHealth Logo
Hospice Administrator
AdventHealth

Ormond Beach, Florida

NEW!
Trinity Health Logo
Urology Opportunity in the Capital District, NY
Trinity Health

Schenectady, New York

NEW!
Harris Health System Logo
Nurse Manager - 4D ICU/IMU Hybrid Unit (Ben Taub Hospital)
Harris Health System

Houston, Texas

NEW!
AdventHealth Logo
Senior Medical Economics Analyst - Hybrid
AdventHealth

Maitland, Florida

NEW!
AdventHealth Logo
Credentialing Specialist
AdventHealth

Maitland, Florida

NEW!
AdventHealth Logo
Patient Registration Coordinator Urgent Care Float Pool
AdventHealth

Maitland, Florida

NEW!
AdventHealth Logo
Consumer Access Specialist PRN
AdventHealth

Riverview, Florida

NEW!
AdventHealth Logo
Patient Service Representative
AdventHealth

Denver, Colorado

NEW!
Trinity Health Logo
Primary Care Opportunities in the Capital District, New York
Trinity Health

Capital District, New York

NEW!
AdventHealth Logo
Consumer Access Specialist Virtual
AdventHealth

Tampa, Florida

NEW!
Executive Director, Tracking California
Public Health Institute

Oakland, California

NEW!
AdventHealth Logo
Patient Service Representative
AdventHealth

Littleton, Colorado

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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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