- Humana (Topeka, KS)
- …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… more
- Elevance Health (Olathe, KS)
- …Prepares recommendations to either uphold or deny appeal and forwards to Medical Director for approval. + Ensures that appeals and grievances are ... for medical necessity. + Extrapolates and summarizes medical information for medical director ,...skills and serves as a subject matter expert for appeals / grievances /quality of care issues and is a… more
- Highmark Health (Topeka, KS)
- …medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances , and other reviews as assigned. Compose clear ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Elevance Health (Topeka, KS)
- …will make an impact:** + Reviews or provides oversight for dental quality of care grievances and appeals . + Reviews or provides oversight as needed for dental ... **State Dental Director ** **Location: This position will work a hybrid...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more