Remote Senior Clinical Appeals & Grievances Specialist
Medica
Medica is a nonprofit health plan serving diverse communities with a mission to provide coordinated, quality care. The Appeals and Grievances Clinical Specialist III role focuses on reviewing, investigating, and resolving member and provider appeals with clinical expertise, ensuring regulatory compliance and quality outcomes. You will collaborate with Medical Directors, clinical staff, and operations to support timely determinations, oversee C2C challenges, and contribute to STARs performance
#J-18808-LjbffrVacancy posted 2 days ago
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