- Elevance Health (Costa Mesa, CA)
- ** Manager II - Grievances & Appeals -** ** Provider Disputes** **Location:** This position will work a hybrid model (in office 1-2 days per week). The ... Open Access Pulse Points listed in this requisition. **The Manager II - Grievances & Appeals...a resource for complex issues and interpretation of claims, provider contracts and data, eligibility, member contracts, benefits, clinical… more
- Elevance Health (Costa Mesa, CA)
- ** Manager I - Grievances & Appeals -** ** Provider Disputes** **Location:** This position will work a hybrid model (in office 1-2 days per week). The ... 50 miles of one of our Open Access Pulse Points listed in this requisition. **The Manager I - Grievances & Appeals ** will be responsible for management… more
- Elevance Health (Costa Mesa, CA)
- …will make an impact:** + Conducts investigations and reviews of member and provider medical necessity appeals . + Reviews prospective, inpatient, or retrospective ... forwards to Medical Director for approval. + Ensures that appeals and grievances are resolved timely to...or any combination of education and experience, which would provide an equivalent background. + Current active unrestricted RN… more