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

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Search Results: 365 Jobs

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Director, Nursing Services - NICU

Phoenix Children's

Phoenix, Arizona

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Radiology Representative II Part Time Evenings

AdventHealth

Celebration, Florida

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Patient Access Representative Part Time

AdventHealth

Hinsdale, Illinois

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Manager of Cardiac Services (Exempt)

Benefis Health System

Great Falls, Montana

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Director of Patient Accounts

WMCHealth

Valhalla, New York

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Family Medicine Opportunity

Trinity Health

Rensselaer, New York

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Practice Supervisor - Urology Outpatient Clinic

Foundation Health Partners

Fairbanks, Alaska

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Consumer Access Specialist

AdventHealth

Tampa, Florida

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Manager,Integrated BHS

WMCHealth

Hawthorne, New York

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Consumer Access Specialist

AdventHealth

Burleson, Texas

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Consumer Access Specialist PRN

AdventHealth

Rome, Georgia

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Radiology Front Desk

AdventHealth

Orlando, Florida

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Director of Care Coordination, (Exempt)

Benefis Health System

Great Falls, Montana

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Black Canyon Primary Care Physician - Optum, Phoenix AZ

Optum

Phoenix, Arizona

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Director of Clinical Operations, Nursing & Patient Care Services

University of Maryland Medical System

Baltimore, Maryland

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Allied Health Assistant Director

Vanderbilt Health

Nashville, Tennessee

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Patient Financial Counselor

AdventHealth

Hendersonville, North Carolina

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Diabetes Management Physician for Nationally Ranked Health System in Central Florida

Orlando Health

Florida

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Chief Executive Officer

ScionHealth

Lake Charles, Louisiana

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Market Chief Executive Officer

Kindred Hospitals

Indianapolis, Indiana

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Practice Manager

WMCHealth

Hawthorne, New York

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Patient Registration Coordinator Urgent Care Float

AdventHealth

Kissimmee, Florida

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Patient Service Representative

AdventHealth

Castle Rock, Colorado

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Patient Service Rep Lead

AdventHealth

Castle Rock, Colorado

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Director, Provider Contracting

Harris Health System

Houston, Texas

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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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