Remote Clinical Appeals & Grievance Lead
GlobalHealth, Inc.
- Remote job
GlobalHealth, Inc. is seeking a Nationally remote, clinical leader to direct Appeals & Grievances operations from Oklahoma City. The role oversees scheduling, resource balance, and the end-to-end appeals/grievances process, ensuring regulatory compliance and timely resolutions for members. The candidate will lead A&G staff, coach team members, and provide daily critical-metrics reporting while maintaining PHI confidentiality. #J-18808-Ljbffr GlobalHealth, Inc.
$102.18k
Job Category: Clinical Location: Los Angeles, CA, US, 90017 Position Type: Full Time... ...that purpose. Job Summary The Lead Appeals and Grievances RN is responsible for assisting with... ...hours, on weekends, holidays, a hybrid remote schedule, and occasional flexibility...Remote workFull timeShift workWeekend work- ...Health Plan in Los Angeles, CA is seeking a Lead Appeals and Grievances RN to help develop and lead a cohesive A&G clinical unit. The role focuses on quality review of complex... ...of healthcare regulations. A hybrid remote schedule is supported along with after-hours...Remote job
$102.18k
...Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals... ...experience. At least 2 years in a lead/supervisory experience. Equivalency:... ...hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours...Remote workFull timeShift workWeekend work$71.59k - $116.48k
A prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case management, understanding of regulatory compliance, and the ability to effectively resolve...Remote job- ...Join The Riverside Medical Clinic Family We have been in the community since 1935... ...and coordinate CPPI. Review/respond to grievances and appeals, monthly medication inventory audit, and... ...quality indicators. This position will help lead the daily operations of grievances and...Suggested
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$248.5k - $373k
...Appeals And Grievances Medical Director At UnitedHealthcare, we're simplifying the health care... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take... ...design and coverage and the application of clinical criteria of medical policies....Remote workMinimum wageWork experience placementLocal areaWork from home$248.5k - $373k
...: 2349628 Job category: Medical & Clinical Operations At UnitedHealthcare, we'... ...You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you... .... Primary Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing...Remote workMinimum wageWork experience placementLocal areaWork from home- ...Sagility is seeking an Appeals and Grievance Coordinator who will manage and resolve member and provider complaints while adhering to regulatory requirements. This role involves conducting investigations, documenting actions, and ensuring compliance. As a key contact for...Remote workWork from home
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$246.1k - $344.2k
...Responsibilities Provide clinical interpretation and... ...decisions on complex appeal cases, exercising... ...to address and resolve grievances and appeals. Participate... ...with prior experience leading teams focusing on... ...profiles. This is a remote position anywhere in the...Remote workFull timeTemporary workFor contractorsApprenticeshipInterim roleWork at officeWork from homeHome officeMonday to Friday- ...Appeals And Grievances Lead 3 Key Consulting is recruiting an Appeals and Grievances Lead for a consulting engagement with our direct client, a leading government-funded managed care health plan. The Lead of Customer Solution Center Appeals and Grievances is responsible...Flexible hoursWeekend work
$17 - $17.99 per hour
...background in managed care operations? We are seeking a dedicated Appeal & Grievance Intake Coordinator to join our Government Solutions team. In... ...closely with cross-functional compliance, legal, and clinical teams to ensure all documentation satisfies precise state and...Remote workHourly payPermanent employmentTemporary workWork experience placementWork at officeShift work- ...A biotechnology firm is seeking an Associate Director, Clinical Site Budgets & Payments to lead the global approach to clinical trial site budgeting and oversight. This remote role involves defining investigator grant strategy, managing CRO performance, ensuring compliance...Remote work
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- ...AUGUST ROSE HEALTH CENTER LLC in Glen Burnie, Maryland, is seeking an experienced Clinical Supervisor for our outpatient mental health clinic. You will provide leadership, guidance, and clinical oversight to our intern therapists and mental health clinicians. The ideal...Remote workFlexible hours
$19 - $29.44 per hour
...Clinic Lead at Xpress Wellness Urgent Care Full Time. Remote: Yes. Telecommute: Yes. Visa sponsorship: No. Compensation: $19 - $29.44 per hour depending on licensure/certification held. Responsibilities Build and manage clinical and clerical schedules, ensuring adequate...Remote workHourly payFull timeVisa sponsorship- ...Who You Are The successful candidate provides daily Clinical leadership and compliance of Appeals and Grievance. Identifying and executing opportunities to... ...completion Work Environment Current work environment is remote; however, some state exclusions apply. Must have...Remote work
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- ...guide and mentor a team of 10‑12 nurse practitioners while seeing a part‑time panel of Virta patients (0.2 FTE). The MD Team Lead advances clinical excellence, provider development, and strategic priorities within the Virta Medical Group. Responsibilities include driving...Remote jobPart time
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