Remote Appeals & Grievances Medical Director
Jobleads-US
Kentucky
- Remote job
UnitedHealthcare is seeking a Medical Director for Appeals and Grievances to oversee clinical review and adjudication across multiple health plans. This remote role requires MD/DO licensure, board certification, and extensive clinical and quality management experience.
You will lead high-stakes decisions, ensure regulatory compliance, and collaborate with medical directors and network staff. The position emphasizes telephonic communication, data analysis, project management, and strategic input
#J-18808-Ljbffr Jobleads-USVacancy posted 4 hours ago
Similar jobs that could be interesting for youBased on the Remote Appeals & Grievances Medical Director in Kentucky vacancy
$248.5k - $373k
...$248,500.00 - $373,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as... .... Primary Responsibilities:The Appeals and Grievances Medical Director is responsible for ongoing clinical...Remote workMinimum wageWork experience placementLocal areaWork from home- ...UnitedHealth Group is seeking a senior Appeals and Grievances Medical Director to lead clinical review and adjudication for UnitedHealthcare and related companies. The role offers work-from-home flexibility across the United States. You will perform case reviews for...Remote jobWork from home
- ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to lead clinical review and adjudication of appeals and grievances across multiple health plan products. This role offers remote work from anywhere in the U.S. and a chance to influence benefit...Remote job
- ...UnitedHealthcare is seeking an experienced Medical Director for Appeals and Grievances, with leadership in clinical review and adjudication across PPO, HMO, MAPD, and PDP products. This remote role supports diverse health plans and requires expert regulatory responses...Remote job
- ...UnitedHealthcare is seeking a clinician to review appeals and grievances across PPO, HMO, MAPD and PDP products. The... ...involves regulatory responses and collaboration with medical directors and network staff. We offer remote work from anywhere in the U.S. The successful...Remote job
$30 - $35 per hour
...Mid-Senior Level professional for a contract role to manage grievances and appeals. Candidates should have 6+ years in customer service with strong... ...pay range of $30.00/hr - $35.00/hr based on qualifications. Remote work is available for candidates within 100 miles of...Remote jobContract workFor contractors$27 - $31 per hour
Pyramid Consulting, Inc. is seeking an Appeals & Grievances Case Manager for a California assignment in Los Angeles. This is a 06+ months contract with potential for extension, and is listed as remote in the LA area. The role requires extensive appeals experience within...Remote jobHourly payContract work- ...UnitedHealth Group is hiring for a remote-friendly clinical leadership role overseeing appeals and grievances across PPO, HMO, MAPD, and PDP products. The position emphasizes collaboration with medical directors and network management to improve access, quality, and outcomes...Remote job
- ...Kern Family Health Care is seeking a Medical Director for Appeals, Grievances & Disputes in Bakersfield, California. This role involves leadership, operational execution, and ensuring compliance with all regulations regarding grievances and appeals. The ideal candidate...
- ...UnitedHealth Group is seeking a physician leader to conduct case reviews for appeals and grievances across multiple health plans. The role involves regulatory responses, collaboration with medical directors, and guidance on benefit interpretations. You will participate in...Remote job
- ...UnitedHealth Group is seeking a Medical Director for Appeals and Grievances to lead clinical review and adjudication of complex cases across multiple health plans. The role offers full remote work from anywhere in the U.S. and requires strong clinical and leadership...Remote job
- Moda Health is seeking a motivated professional to investigate and respond to medical, pharmacy and dental grievances, complaints, and appeals. This is a full-time work-from-home position within Government Programs. Responsibilities include thorough case review, timely...Remote jobFull timeWork from home
$236.5k
...clinical professional on our Medical Management/Health Services team... .... Assists Chief Medical Director in planning and establishing... ...clinical teams, network providers, appeals team, medical and pharmacy... ...flexible approach to work with remote, hybrid, field or office work...Remote jobFull timePart timeWork at officeFlexible hoursWeekend work$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$195.2k - $341.6k
...Overview Job Summary: The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical... ...as requested Provide physician review for clinical appeals cases Participate in the evaluation and investigations of...Remote jobHourly payWork at officeWeekend workAfternoon shift$236.5k
...clinical professional on our Medical Management/Health Services team... ...Purpose Supervisory Medical Director at Centene provides medical... ...actively participates in the appeals process, ensuring that appeals... ...flexible approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hours- 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 VNS...Remote job
- 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
Healthfirst
New York, NY15 hours ago - ...To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members and providers while ensuring compliance with applicable requirements. Key responsibilities Manage and resolve complaints...Remote workFull time
Virtual Vocations Inc
United States15 hours ago - A staffing solutions company is seeking a Grievance & Appeals Coordinator for a fully remote position in Detroit, MI. This role involves processing appeals, grievances, and inquiries while maintaining accurate documentation and effective communication. The ideal candidate...Remote jobContract work
- ...-making across health insurance products and medical management programs. The Medical Director is a highly experienced medical professional... ...supports complex clinical decision-making including appeals, rescissions, and grievance reviews, while also partnering with legal,...Remote workContract workWork at officeWork from homeWork visaShift work
Allstate Insurance Company
United States1 day ago $280.84k - $393.18k
...President of Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical... ...activities including quality management, grievance and appeals, delegation oversight, and population... ...a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho...Remote workTemporary workLocal area- ...escalated cases electronically and using Medical Policy criteria sets to evaluate the... ...determination of cases, review of appeals and grievances, and other reviews as assigned. Compose... ...with MCG or InterQual Must complete the Medical Director Assessment...Remote workPrivate practice
ATD Technology LLC
United States2 days ago - Firstsource Healthcare is seeking a detail-oriented Claims & Appeals & Grievances (A&G) Specialist to join our Healthcare Operations team. The candidate should have at least two years of experience in US healthcare back-office operations with expertise in claims processing...Remote job
$290k - $350k
...), we provide comprehensive medical care along with support for... ...Scope: The Medical Director is the senior clinical... ...PACE regulations; oversees grievances, appeals, CLIA-waived onsite lab compliance... ...administrative, community, or remote environments, depending on...Remote workContract workTemporary workFor contractorsFixed term contractWork at officeLocal areaWork from homeFlexible hoursHabitat Health
Chicago, IL1 day ago- ...Job Title Job Description Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established... ...and applying contract and regulatory provisions. This is a Remote Role Experience Experience handling a large load of work in...Remote workContract workApprenticeshipLocal area
LanceSoft
United States15 hours ago $173k - $250k
...circumstances. Job Summary: The Medical Director will report to the Senior Medical... ...Director of Utilization Management, Member Appeals & Grievances, and Medical Policy (Senior Medical... ...Our Investment in You: • Full-time remote work • Competitive salaries •...Remote workFull timeWork at officeFlexible hoursBMC HealthNet Plan
United States3 days ago- ...Medical Director – Utilization Management The remaining 5 positions will be in Non-Behavioral... ...similar candidates. Location: Remote – Preference EST or nearby Pittsburgh... ...Complete initial determinations, appeals, grievances, and other reviews as assigned. Compose...Remote workContract workPrivate practice
InterSources
United States3 days ago $170 - $190 per hour
...Medical Director Huntington Beach Office - Huntington Beach, CA 92647 Overview Salary Range $170.00 - $190.00 Hourly Position... ...for MAPD utilization management, care management, appeals and grievances, quality-of-care review, delegated clinical functions, and...Remote workHourly payPart timeWork at officeClever Care Health Plan
United States1 day ago$160 - $170 per hour
...Medical Director Req number: R8254 Employment type: Full time Worksite flexibility: Remote Who we are CAI is a global services firm with over 9,000 associates... ...determination of cases, review of appeals and grievances, and other reviews as assigned...Remote workHourly payFull timeApprenticeshipPrivate practiceWork at officeLocal areaWorldwideCAI
Nashville, TN4 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Appeals & Grievances Medical Director. Be the first to apply!
Related searches
- medical director oncology Kentucky
- health manager Kentucky
- remote medical billing manager Kentucky
- public health director Kentucky
- healthcare supervisor Kentucky
- psychiatry medical director Kentucky
- remote medical coding supervisor Kentucky
- clinical manager Kentucky
- health economics manager Kentucky
- clinical data manager remote Kentucky