Remote Medicare Appeals & Grievance Case Manager
$20 - $30 per hourPyramid Consulting, Inc
- Remote job
Pyramid Consulting, Inc in California is seeking a Member Appeals & Grievance Case Manager for a 6+ month contract with long-term potential. This remote position requires expertise in managing complaints and grievances in compliance with health plan standards. Ideal candidates will have over 3 years of experience in Appeals or Care Coordination, with a strong understanding of CMS regulations. The position offers a pay range of $20 - $30 per hour. #J-18808-Ljbffr Pyramid Consulting, Inc
$30 - $35 per hour
...seeking a Mid-Senior Level professional for a contract role to manage grievances and appeals. Candidates should have 6+ years in customer service with... ...range of $30.00/hr - $35.00/hr based on qualifications. Remote work is available for candidates within 100 miles of...Remote workContract workFor contractors$20 - $30 per hour
...Case Manager Appeals & Grievances (California) Immediate need for a talented Case Manager Appeals & Grievances (California). This is a 06+ months... ...opportunity with long-term potential and is located in California (Remote). Please review the job description below and contact me...Remote workContract workLocal areaImmediate start- ...BroadPath is looking for a Work from Home Appeals and Grievance Specialist to support members with their benefits... ...4+ years of experience in Utilization Management and strong customer service skills. This position offers a remote work opportunity and requires effective...Remote workWork from home
- ...BlueCross BlueShield of Tennessee is hiring an Appeals & Grievance Nurse Analyst. This remote position involves reviewing appeals from members, ensuring timely resolutions in compliance with CMS and Medicare guidelines. The ideal candidate should have at least 3 years...Remote workWork at office
- Blue Shield of CA is seeking a Medicare Appeals RN Senior in Los Angeles, CA. This role involves reviewing member appeals and grievances, ensuring compliance with Medicare/National guidelines... ...for hybrid virtual work, balancing remote responsibilities with in-office...Remote workWork at office
$65k - $88.6k
Humana is seeking a Senior Grievances & Appeals Analyst to analyze and audit complaints, ensuring the integrity of claims and authorization processes. This role involves utilizing data analysis tools and performing root cause analysis of audit findings to recommend improvements...Remote jobWork from homeFlexible hours- ...RediMinds, Inc is looking for a detail-oriented Review Case Manager based in Southfield, Michigan. This fully remote role involves processing Independent Review Organization (IRO) and Utilization Review (UR) appeals/requests from start to finish. The ideal candidate...Remote work
$248.5k - $373k
...enjoy the flexibility to work remotely * from anywhere within the U... ...Responsibilities: The Appeals and Grievances Medical Director is responsible... ...of appeals and grievances cases for UnitedHealthcare associated... ...of Insurance/Department of Managed Healthcare, and CMS...Remote workMinimum wageWork experience placementLocal areaWork from home$51.41k - $83.6k
...Overview of Duties The Appeals Case Manager exercises responsibility for processing cases through all stages of the appellate process, from initial receipt through final disposition. The major responsibilities and duties include the following: Collect case opening...Remote workWork experience placementLocal areaFlexible hoursWeekend work- ...Position Grievance and Appeals Coordinator Position Description... ...our Grievance & Appeals Nurse Manager and Grievance Supervisor,... ...processing Grievance and Appeal cases, ensuring compliance, and... ...environment, with prior Medi-Cal and Medicare experience preferred....Remote workWork at officeImmediate startWork from home
$21.16 - $38.37 per hour
Join to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at Molina Healthcare . This position is remote and will be working Pacific Standard hours. Highly Qualified... ...Qualifications At least 2 years of managed care experience in a call center,...Remote workHourly payFull timeContract workWork experience placementWork at office$248.5k - $373k
...ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. Remote work: Work at home or from anywhere within the... ...Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses....Remote workWork experience placementLocal areaWork from home$246.1k - $344.2k
...involves collaboration with various teams to address grievances and appeals. With responsibilities in a remote setting, the role offers a competitive salary range... ...candidates will have strong knowledge of the managed care industry and at least five years of clinical experience...Remote work- ...A leading health care provider in Los Angeles is seeking a Manager, Appeals and Grievances. This full-time position involves overseeing the intake, logging, and resolution of member appeals and grievances. The ideal candidate should have extensive experience in health...Remote workFull time
$248.5k - $373k
...Medical Director responsible for reviewing appeals and grievances within various health products. The... ...of clinical practice and Quality Management experience. Compensation ranges from $... ...comprehensive benefits package available for remote employees within the U.S. #J-18808-...Remote 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 workContract work
$248.5k - $373k
...seeking a Medical Director for the clinical review of appeals and grievances cases, allowing remote work from anywhere in the U.S. This role involves... ..., along with extensive clinical practice and quality management experience. The compensation ranges from $248,500 to...Remote work$248.5k - $373k
...Crains Cleveland seeks a qualified MD or DO for a remote position focused on managing health plan appeals and grievances. The role requires extensive clinical experience and the ability to communicate effectively with medical directors. You will also provide clinical...Remote work$248.5k - $373k
...Corporation is hiring a Medical Director specializing in Appeals and Grievances, offering the flexibility to work remotely from anywhere in the U.S. This role involves... ...experience, along with skills in project management and data analysis. Competitive compensation ranging...Remote work$248.5k - $373k
...Join UnitedHealthcare as an Appeals and Grievances Medical Director, working remotely from anywhere in the U.S. You'll oversee appeals and grievances for various health plan products while collaborating with medical directors. The role requires an MD or DO with board certification...Remote work- ...is seeking a qualified Medical Director to perform case reviews for appeals and grievances within various health plans. The role involves... ...years of clinical practice, and expertise in quality management. This is a remote position available within the U.S. with a strong benefits...Remote work
- ...WellSense Health Plan is seeking a dedicated Appeals and Grievance Specialist to oversee member appeal processes and manage grievances effectively. This full-time remote role requires experience in managed care and Medicare, as well as strong problem-solving and communication...Remote workFull time
- Humana Inc. is seeking a remote Corporate Medical Director to provide clinical interpretation and decision-making on healthcare... ...involves collaborating with cross-functional teams to resolve grievances and appeals while maintaining compliance with healthcare regulations....Remote job
$269.5k - $425.5k
UnitedHealth Group is looking for an Appeals and Grievances Medical Director in Boston, MA. This role involves reviewing clinical appeals and grievances... ...board certification and significant clinical experience. Remote work is possible. Competitive salary range is $269,500 to $4...Remote job$248.5k - $373k
UnitedHealth Group is looking for an Appeals and Grievances Medical Director to oversee clinical reviews... ...role offers the flexibility to work remotely from anywhere in the U.S. Key responsibilities include reviewing appeals cases, communicating with medical staff, and...Remote job- ...interpretation, making independent medical decisions on complex appeal cases, and collaborating with teams on grievances. The ideal candidate will have an MD or DO degree,... ...and at least 5 years of clinical experience. This remote position offers competitive compensation and...Remote job
$248.5k - $373k
...enjoy the flexibility to work remotely from anywhere within the U.S... ...Responsibilities The Appeals and Grievances Medical Director is responsible... ...adjudication of appeals and grievances cases for UnitedHealthcare... ...of Insurance/Department of Managed Healthcare, and CMS regulatory...Remote jobMinimum wageWork experience placementLocal areaWork from home$248.5k - $373k
...seeking a Medical Director for Appeals and Grievances to oversee ongoing clinical... ...experience, including quality management. Key responsibilities include reviewing cases related to medical service provisions... .... The position offers remote work flexibility and a comprehensive...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 job
$248.5k - $373k
UnitedHealth Group is looking for an Appeals and Grievances Medical Director to oversee clinical... ...role offers the flexibility to work remotely from anywhere in the U.S. and involves... ...have extensive clinical and Quality Management experience. Compensation typically ranges...Remote job
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