Remote Appeals & Grievances Medical Director
ISHE
Dallas, TX
- Remote job
UnitedHealth Group is seeking a Medical Director to lead appeals and grievances reviews for multiple health plans, including regulatory responses and clinical criteria adjudication. The role requires MD/DO with license, board certification, and 5+ years of clinical practice, with 2+ years in quality management. Remote work is available, with some in-office requirements in certain regions. Strong communication, data analysis, and project management skills are essential. #J-18808-Ljbffr ISHE
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Appeals & Grievances Medical Director in Dallas, TX 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$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- A prominent healthcare organization is seeking an Appeals and Grievances Medical Director to manage clinical reviews of appeals for various health plans. The role offers flexibility to work remotely. Qualified candidates should have an MD or DO, be board certified, and...Remote job
- 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
- ...Grievance & Appeals Coordinator Are you an analytical problem solver with a passion for healthcare managed care? We are seeking dedicated... ...Coordinators to join our growing, collaborative team! In this fully remote role, you will analyze and resolve complex member and...Remote workWork from homeHome officeWeekend work
Randstad
United States19 hours ago - ...Grievance & Appeals Coordinator Are you a detail-oriented managed care professional looking for an exciting work-from-home opportunity in Iowa? We are seeking a self-motivated, organized Grievance & Appeals Coordinator to join our dynamic team! In this essential role...Remote workWork from home
Randstad
United States5 days ago $236.5k
...clinical professional on our Medical Management/Health Services team... ...\n Assist the Chief Medical Director to direct and coordinate the... ...clinical teams, network providers, appeals team, medical and pharmacy... ...approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hoursWeekend workCentene
Trout Lake, WA4 hours ago- UnitedHealthcare is seeking a Medical Director to lead appeals and grievances review for multiple health plans. You will adjudicate cases, apply clinical... ...ensure compliant, patient-centered decisions from a remote setting. This role requires MD/DO with active license...Remote job
- 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
- ...offering UnitedHealthcare services, invites an experienced clinician to join our remote team. You will review appeals, respond to regulatory bodies, and coordinate with medical directors to interpret benefits and access issues. The role requires an MD/DO with active license...Remote job
- ## Director, Appeals and GrievanceApplyremote type: Remotelocations: Virginia... ...The Director of Appeals and Grievance will plan, develop, and... ...Director works closely with the Medical Directors to identify trends... ...(Required)**Location*** Remote**Experience*** Minimum five...Remote workTemporary workShift work
$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$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director works... .../ HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome office$19.76 per hour
...opportunity in Iowa? We are seeking a self-motivated, organized Grievance & Appeals Coordinator to join our dynamic team! In this essential role... ...offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings...Remote workHourly payPermanent employmentTemporary workWork experience placementWork at officeWork from homeHome officeMonday to FridayShift workWeekend workRandstad
United States3 days ago$22.99 per hour
...healthcare managed care? We are seeking dedicated Grievance & Appeals Coordinators to join our growing, collaborative team! In this fully remote role, you will analyze and resolve... ...benefits package, including: medical, prescription, dental, vision, AD&D, and...Remote workHourly payPermanent employmentTemporary workWork experience placementWork at officeWork from homeHome officeShift workWeekend workRandstad
United States3 days ago- 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
United States2 days ago $19.43 - $32.98 per hour
...Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Key Details: This position is remote/work from home. Prefer applicants who reside in the state of Illinois. Role...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hoursCentene Corporation
United States5 days ago$191.5k - $355.6k
...Job SummaryThis position is responsible for assigned aspects of medical policies and programs. Performs medical reviews and interacts... ...internal medicince specialties preferred but nt required This is a remote work from home role #LI-MG1Are you being referred to one of our...Remote workFull timeWork at officeWork from home- ...for a high-level clinical specialist to review appeals and manage quality programs. This role offers remote work from anywhere in the U.S. and opportunities... ...regulatory responses, and communications with medical directors. Required credentials include an active MD/DO license...Remote job
- ...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 States2 days ago - ...ü Technology Partners is seeking a Med Appeals & Grievance Specialist Coordinator (Clinical) for a... ...on appeals, benefit determinations, and medical denials with a background in managed... ...coordinating with internal departments. Remote work is available; schedule 8:00-4:30 Mountain...Remote jobContract work
- 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
- Centene is seeking a clinical professional to join our Medical Management/Health Services team to ensure proper processing of member grievances, provider appeals, and state fair hearings. You will serve as the primary contact with the State and oversee the daily activities...Remote job
- ...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
LanceSoft
United States1 day ago - Apolis is seeking a Grievance and Appeals RN in Phoenix, AZ (or remote within AZ time zone) to review and investigate member and provider grievances and appeals... ...for Medicare Part C and Part D. The nurse reviews medical records, claims, authorizations, and plan benefits...Remote job
- 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
$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- 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...
- ...Medical Director This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance... .... Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise...Remote workPrivate practice
eTeam
United States5 days ago - ...Candidates must have an active medical license in PA, NY, or WV , or be willing... ...for this role. Description: Medical Director Job Description This job, as part of... ...initial determination of cases, review of appeals and grievances, and other reviews as assigned....Remote workPrivate practice
Saxon Global
United States4 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
- project manager health Dallas, TX
- healthcare consulting manager Dallas, TX
- clinical nutrition manager Dallas, TX
- director of health information management Dallas, TX
- hospital manager Dallas, TX
- clinic operations manager Dallas, TX
- health insurance manager Dallas, TX
- hospital supervisor Dallas, TX
- healthcare account manager Dallas, TX
- clinical director Dallas, TX