• Medicare Grievances

    Humana (Annapolis, MD)
    …Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
    Humana (06/23/24)
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  • Medical Review & Appeals Director (Hybrid)

    CareFirst (Baltimore, MD)
    …health insurance environment with a focus on Clinical Medical Review and Appeals and Grievances . **Preferred Qualifications:** + Applicants with specific ... experience in Medicare and / or Medicaid appeals are...the interdependencies between Medical Policy, Clinical Medical Review and Appeals and Grievances . + Ability to mentor… more
    CareFirst (05/07/24)
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