Head of Clinical Appeals & Grievances
Healthfirst
Healthfirst in New York is seeking a Manager, Clinical Appeals & Grievances to lead a fast-paced team and optimize processes across the organization. This role collaborates with multiple leaders to standardize workflows, address priority focus areas, and drive performance for compliance and quality across internal and external production teams. You will oversee production, ensure timely case resolution, and guide decision-making while aligning with long-term growth and profitability goals of #J-18808-Ljbffr Healthfirst
- VNS Health is seeking a remote Clinical Education Manager to plan, implement, and evaluate education programs for staff across... ...Bachelor’s and often a Master’s in Nursing, plus five years in Grievance and Appeals or similar clinical education settings. #J-18808-Ljbffr...SuggestedRemote job
$176.6k - $294.3k
...as the hands-on, proactive, strategic leader responsible for advancing the application of Artificial Intelligence (AI) across the Clinical Development lifecycle. You will partner closely with the Oncology Clinical Development, Clinical Operations, Biostatistics, Data Science...SuggestedPermanent employmentFull timeH1bLocal areaVisa sponsorshipWork visaRelocation package2 days per week- ...Head of Clinical Operations About Conduit Health Conduit Health is transforming the hardest, most outdated corner of post-acute care: getting essential medical equipment and supplies into patients' homes. We are the first vertically integrated, AI-powered platform that...SuggestedWork from home
- ...Job Title: Head of Clinical Operations, Vaccines Location: Swiftwater, PA (Preferred); Waltham, MA About the Job As Head of Clinical Operations within our Global Clinical Development team, you'll lead a world-class global platform to deliver the full vaccines clinical...SuggestedFor contractors
- Blossom Health in New York City is seeking a Head of GTM to build and lead one of Blossom’s most important growth channels. You’ll start... ...the Founder CEO, with a path to national expansion and a scalable Clinical Partnerships organization. #J-18808-Ljbffr Blossom ServicesSuggested
- Blossom Health is seeking a Head of Field Sales & Strategy to build and lead one of Blossom’s most important growth channels. You’ll develop the Clinical Partnerships motion with PCPs and healthcare providers, define ICP, test sales motion, and shape a scalable go-to-market...Full time
- Elemed seeks a Head of Clinical Development in New York to own assets end to end, reporting to the CEO. You will direct a small, autonomous team and orchestrate a fleet of AI agents for document drafting, literature surveillance, safety signals, and data triage. This role...
$175k - $190k
...build out a team from scratch in partnership with the broader Provider and Patients Operations team. What You’ll Be Doing Platform Clinical Standards Create scope-of-practice guardrails to define what practicing as a provider on Fay entails Define Fay’s clinical...- ..., and defensibility of the department’s clinical decisions. Clinical review is the core of... ...rationale that is defensible on appeal, external review, and audit. Conducts... ...Provides clinical input on member and provider grievances and reviews complaint resolution outcomes...Work at officeLocal areaFlexible hours
- ...leading oncology programmes inside large pharma or building out clinical teams at a biotech. The question is whether you want to keep doing... ...its ambition needs someone to own those assets end to end. As Head of Clinical Development, you will report directly to the CEO and...Relocation package3 days per week
- ...Job Description Job Description We are looking for a competent Head of Clinical Operations who will own critical functions across the business, including expansion strategy, new vertical launches, supply chain management, clinical team management, product operations...Shift work
- Sanofi is seeking a Head of Clinical Operations for Vaccines to lead a global platform delivering the full vaccines portfolio. You will oversee a team of 80-120 professionals across regions, drive end-to-end operational delivery, and shape strategy with a budget around...
- Blossom Health is seeking a Head of Field Sales & Strategy in New York City to build and lead a new growth engine focused on clinical partnerships with PCPs and providers. You will define ICP, test motion, scale to national reach, and own the numbers with a data-driven...
$330.2k
A leading pharmaceutical company in Pennsylvania is seeking a Development Head to manage and oversee vaccine clinical research and development programs. You will lead global clinical programs, ensure successful implementation, and develop innovative strategies to resolve...- ...that engage employees in prevention, primary care, and chronic condition management within the benefits strategy. You'll lead the clinical engagement strategy across health care programs, collaborate with HR and external partners, and drive the evolution of our navigation...
- ...seeking a Director of the Metabolic Bone Disease Program. This leadership role requires expertise in metabolic bone disease, overseeing clinical services and research initiatives. The successful candidate will enhance osteoporosis care and collaborate with multidisciplinary...
- K Health is seeking a senior Recruiter to lead nationwide hiring for primary care clinicians across all 50 states, partnering with the CMO and health system partners to align talent with growth. You will create scalable, playbook-driven sourcing for a rapidly expanding ...
$28.53 per hour
Overview Position Type: Health Care Positions/ Health Specialist: Head Start Date Posted: 3/11/2026 Location: LEBANON ONE CUMBERLAND STREET Date Available: ASAP Status: Full-time Schedule: 7.00 Hours/Day (8:00 am-3:30 pm); Monday-Friday 260 Days/Year Hourly Salary...Hourly payFull timeWork at officeLocal areaImmediate startMonday to Friday- black.ai is seeking a Sales Director based in New York to lead and grow sales in North America. This role involves recruiting and coaching a high-performing team while leveraging existing product demand to achieve significant revenue targets. The ideal candidate will have...
- Enhanced seeks a seasoned product development leader to own the product portfolio across prescription medications, supplements, and emerging health categories. You will coordinate with medical teams, pharmacies, and contract manufacturers to bring products from concept ...Contract work
$150k - $250k
...partnering with psychiatrists to expand access to affordable, timely, clinically-effective mental healthcare. Our AI-native care platform is... ...Health, and Enzo Health. The Role: We’re looking for a Head of Clinical Partnerships to build and lead one of Blossom’s...Full timeWork at office- Vocca is hiring a Founding Head of Sales for the US market from New York. You will build, lead, and scale the US revenue engine, starting hands-on by closing deals with our founding AEs, then hiring and coaching a top-tier team. We’re aiming for a zero-to-one US GTM leader...
$224k - $311k
...silos; instead, we partner with the world's leading fitness apps, clinical institutions, and medical record networks to bring a user’s... ...scale a platform that helps millions live healthier lives! As the Head of Health Enterprise Partnerships, you will be the strategic architect...Live in$235k - $245k
...coordinating primary care services for clients across shelter-based clinics and mobile medical services. Reporting to the Chief Medical... ...Assurance processes, including Incident Review meetings and Grievance Committee meetings. Ensures that primary care services delivered...Work at officeLocal area$85k
...OVERVIEW Under the supervision of the Program Director, provide clinical oversight for staff and clients consistent with maximizing... ...evaluations and performance improvement plans. Reports all grievances and incidents to the Program Director and assists with...Full timeWeekend workAfternoon shift- Gravie is seeking a high-caliber sales leader to expand our health-benefits offerings for small and mid-size businesses in Georgia. You will target brokers and consultants, develop regional plans, and drive the full sales cycle from prospecting to close, delivering consistent...
- ...that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role As Pivotal’s Head of Marketing, Health Systems; you will have the opportunity to build and lead the Health Systems marketing strategy from the ground...Remote workFlexible hours
- Soho House & Co. in New York seeks a senior leader to drive performance, growth, and innovation for Health Clubs across North and South America. You will manage 7 clubs, oversee 6 markets, and guide ~20 team members in Spa, Gym, and Longevity Studio operations. You will...
- ...review escalated cases, evaluate medical necessity, and support appeals while guiding policy and disease management initiatives. You... ...discussions, ensure regulatory compliance, and collaborate across clinical and compliance teams to improve care processes. Remote work is...Remote work
- A healthcare technology company is seeking a Head of Product Strategy, Marketing & Management to define and execute product lifecycle strategies for payer solutions. The ideal candidate will possess over 10 years of experience in Product Management and a deep understanding...
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