- Elevance Health (Topeka, KS)
- ** Provider Grievance and Appeals - Business Change Advisor** **Location: Topeka KS, or Olathe, KS** This position will work a hybrid model (remote and ... of one of our Kansas Elevance Health PulsePoint locations. The ** Provider Grievance and Appeals - Business Change Advisor** is responsible for… more
- Humana (Topeka, KS)
- …to protect member PHI / HIPAA information This is a remote position reporting to Grievance and Appeals Director or MD Team Lead **Scheduled Weekly Hours** 40 ... Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director reviews cases of diverse scope and complexity… more
- Humana (Topeka, KS)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or...member population, or condition type. May also engage in grievance and appeals reviews. Some medical directors… more
- Humana (Topeka, KS)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease...member population, or condition type. May also engage in grievance and appeals reviews. May participate on… more
- CVS Health (Topeka, KS)
- …management, care management, claims adjudication, pharmacy utilization, quality improvement, grievance and appeals , policies and procedures, and responsible ... programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies, and programs are… more
- Humana (Topeka, KS)
- …in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational ... directors are expected to understand Humana processes with a focus on collaborative business relationships. The ideal candidate will have a high degree of integrity,… more
- Humana (Topeka, KS)
- …in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. Some medical directors may join a centralized team ... or Corporate Medical Director, depending on size of region or line of business . The Medical Director conducts Utilization Management of the care received by members… more
- Humana (Topeka, KS)
- …and/or the Project Management Institute + Knowledge of Medicare Advantage + Grievance and Appeals experience **Additional Information** Work Schedule: Monday - ... be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet… more