Job Seekers, Welcome to NAMSS Career Center
Search Filters
Use this area to filter your search results. Each filter option allows for multiple selections.
Featured! Featured!
NEW! NEW!
Northeast Georgia Health System
Braselton, Georgia
NEW! NEW!
Veterans Affairs, Veterans Health Administration
Sioux Falls, South Dakota
NEW! NEW!
Duke University Health System
Durham, North Carolina
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
Veterans Affairs, Veterans Health Administration
Saint Louis, Missouri
NEW! NEW!
Lehigh Valley Health Network
Hazleton, Pennsylvania
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
Atlantic Health System
Morristown, New Jersey
NEW! NEW!
NEW! NEW!
NEW! NEW!
NEW! NEW!
Loading... Please wait.
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.
Loading. Please wait.