Remote Medical Director, Appeals & Grievances
UnitedHealth Group
- Remote job
The Appeals and Grievances Medical Director at UnitedHealthcare oversees ongoing clinical review and adjudication of appeals and grievances for multiple health plans. You will apply clinical criteria, communicate decision rationales, and coordinate with medical directors and network staff to ensure accurate benefit interpretations. This role offers full remote work across the United States, with limited in-office requirements in certain markets; requires MD or DO with an active license, board #J-18808-Ljbffr UnitedHealth Group
- ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to lead clinical review and adjudication across multiple plans. The role emphasizes... ...with medical directors and network management. Remote work within the U.S. is supported, with a focus on improving...Remote work
$248.5k - $373k
...Appeals And Grievances Medical Director At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing... ...Work at home! You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough...Remote jobMinimum wageWork experience placementLocal areaWork from home- UnitedHealthcare, a UnitedHealth Group company, is seeking a Medical Director to lead appeals and grievances clinical review for multiple health plans. The role... ...in clinical practice and quality management. Remote work options within the U.S. are available. #J-18808...Remote job
$174.07k - $374.92k
...& West Virginia). **This is a remote based (work at home) based anywhere... ...US.** Responsibilities of this Medical Director role are related to Medicaid Appeals You will support the Medical... ...and consultation to the Medicaid grievance and appeals team You will chair...Remote workHourly payFull timeTemporary workLocal areaWork from home- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote work
- ...Workday is seeking a Grievance & Appeal Specialist to address appeals within required timeframes and ensure contractual obligations are met.... ...Procedures to ensure compliance with regulatory standards. This remote position requires strong communication, confidentiality, and...Remote work
$191.5k - $355.6k
...development. This position is responsible for assigned aspects of medical policies and programs. Performs medical reviews and interacts... ...medicine specialties preferred but nt required This is a remote work from home role Compensation: $191,500.00 - $355,600.00...Remote workWork at officeWork from home- ...Insurance services, seeks an accomplished Medical Appeals Coordinator Position: Medical Appeals... ...!!! Pay rate: $24/hr on W2 Note: REMOTE role with possibility The schedule for... ...non-complex pre-service and post service grievances and appeals requests from customer...Remote workTemporary workLocal areaFlexible hours3 days per week1 day per week
$103.4k - $149.43k
The Manager, Clinical Appeals & Grievances is responsible for leading, operating, and advising a dynamic and fast-paced Clinical Appeals... ...Provides guidance in the preparation of case preparation for Medical Director Review ensuring that all pertinent information (i.e. case...Contract workTemporary workWork experience placementLocal areaFlexible hours$191.5k - $355.6k
...development. This position is responsible for assigned aspects of medical policies and programs. Performs medical reviews and interacts... ...medicince specialties preferred but nt required This is a remote work from home role (#LI-MG1). Pay Transparency Statement...Remote workWork at officeWork from home- Banner Plans & Networks is seeking a Grievance and Appeals Coordinator to manage intake, review, investigation, and resolution of grievances,... ...providers to ensure compliant, timely responses. Position primarily remote with Arizona residency required for consideration; standard...Remote jobMonday to FridayShift work
- Elevance Health is seeking an entry-level Grievance/Appeals Analyst I to review and process non-complex grievances and appeals for multiple product types and customer categories. This remote role supports flexible, compliant handling of clinical and non-clinical issues...Remote jobFlexible hours
$23.22 - $34.84 per hour
A leading health insurance provider is seeking a Grievance & Appeals Coordinator to work virtually full-time, with responsibilities including summarizing complaints, ensuring resolution of grievances, and documenting interactions. The ideal candidate should possess a high...Remote workHourly payFull time$23 per hour
TEKsystems is seeking a Contract Grievances and Appeals Specialist for a fully remote role based out of Columbus, OH. The position analyzes and resolves verbal and written claims and appeals from providers and members, and prepares response letters. This is a contract...Remote jobHourly payContract work- ## Medical DirectorApply: Fully Remote: US - Remote: Full time: Posted Today: R35494At Allstate, great... ...programs. The Medical Director is a highly experienced physician... ...clinical decision-making, including appeals, rescissions, grievance reviews, and Department of Insurance...Remote workFull timeContract workWork at officeWork from homeWork visa
- ...solutions to our clients world-wide. Job Title: Medical Director Location: Remote Duration: 6 Months Job Type: Temporary... ...Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and...Remote workTemporary workPrivate practice
$173k - $250k
...than 25 years ago as Boston Medical Center HealthNet Plan, we provide... ...Job Summary: The Medical Director will report to the Senior... ...Management, Member Appeals & Grievances, and Medical Policy (Senior... ...normally performed in a typical remote interior/office work environment...Remote workWork at officeFlexible hours$223.8k - $313.1k
...part of our caring community The Medical Director, National Outpatient Medicare leverages... ...as clinical documentation, coding, grievances and appeals, and outpatient services or equipment... ...organizational committees. Work Style Remote - Occasional travel to Humana's...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$123.37k - $161.93k
...'re Oscar. We're hiring an Associate Director, Appeals & Grievances to join our team. Oscar is the first... .... Work Location: This is a remote position, open to candidates who reside... ...are eligible for benefits including: medical, dental, and vision benefits, 11 paid...Remote workFull timeWork from homeHome office- ...Strategic Staffing Solutions is currently looking for a Grievance & Appeals Coordinator, a W2 contract engagement with one of our largest clients in Detroit, MI! REMOTE!! Title: Grievance & Appeals Coordinator Location : Detroit, MI (Fully Remote) Duration:...Remote workContract work
- ...), we provide comprehensive medical care along with support for... ...Role Scope: The Medical Director is the senior clinical leader... ...PACE regulations; oversees grievances, appeals, CLIA-waived onsite lab compliance... ..., community, or remote environments, depending on role...Remote workFor contractorsWork at officeWork from home
$150 per hour
...Job Title: Medical Director Location: 100% Remote Employment Type: Contract (W2) Duration: 6+ Months Rate: $150/hr... ...appropriateness of care. Conduct initial determinations, appeals, grievances, and other utilization reviews. Participate...Remote workHourly payContract work- ...and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across... ...a strong background in clinical review, medical necessity denials, payer appeal processes... ...commercial plans. Experience managing remote and/or offshore teams (Philippines...Remote work
$46.37k - $60.86k
...hiring a Specialist, Admin Complaints, Grievances & Appeals to join our CGA & MPCT team. Oscar is... ...Lead. Work Location: This is a remote position, open to candidates who reside... ...employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid...Remote jobFull timeWork at office$54.37k - $117.81k
...responsible for the submission/resolution of member and provider appeals and grievances; ensures resolutions are compliant with applicable... ...leadership experience. • Experience reviewing all types of medical claims (e.g. HCFA 1500, Outpatient/Inpatient UB92, Universal...Remote workFull timeWork at office- About The Role The Medical Director performs utilization review and medical... ...assignment. *This is a Remote Role Primary Responsibilities... ...rationale that is defensible on appeal, external review, and audit.... ...on member and provider grievances and reviews complaint resolution...Remote workWork at officeFlexible hours
$22 - $23 per hour
...Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity with long-term potential and is US ( Remote ). Please review the job description below and contact... ...not limited to, health insurance (medical, dental, vision), 401(k) plan, and...Remote workContract workWork at officeLocal areaImmediate start$22.49 per hour
As a Grievance and Appeals Coordinator, you will spend your day acknowledging and resolving member... ...operations. Participate actively in a remote, collaborative environment (Note:... ...comprehensive benefits package, including: medical, prescription, dental, vision, AD&D,...Remote workHourly payPermanent employmentTemporary workWork experience placementShift work- ...Job Title Job Description Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established... ...applying contract and regulatory provisions. This is a Remote Role Experience Experience handling a large load of...Remote workContract workApprenticeshipLocal area
$300k - $350k
...We are looking for a SENIOR MEDICAL DIRECTOR who can help shape our vision... ...determinations and clinical appeals of denied medical... ...Ability to apply complaint, grievance, and appeal processes and procedures... ...a blend of ‘In-Office’ and ‘Remote.’ We are not able to support...Remote workTemporary workWork at officeLocal areaFlexible hours
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