- Elevance Health (Topeka, KS)
- …Grievance and Appeals Program Manager, Senior** will be responsible for managing Provider Grievances, Provider Appeals , and Provider State Fair ... ** Grievance and Appeals Program Manager, Senior**...varied projects, programs and plans that support achievement of business unit and enterprise goals. **Primary duties to include,… more
- Elevance Health (Topeka, KS)
- ** Grievance / Appeals Analyst I** **Candidates must be located within 50 miles of Topeka, KS** The ** Grievance / Appeals Analyst I** is an entry level ... position in the Enterprise Grievance & Appeals Department that reviews, analyzes...and Experiences:** + Ability to research preferred. + Demonstrated business writing proficiency, understanding of provider networks,… more
- Elevance Health (Topeka, KS)
- ** Grievance / Appeals Analyst Lead** **Candidates must be located within 50 miles of Atlanta, GA, Miami, FL, Mason, OH, Norfolk, VA, Tampa, FL, or Topeka, KS** The ... ** Grievance / Appeals Analyst Lead** is responsible for leading...a quality manner. + May also be responsible to provide review and analysis of complex pre service and… more
- Humana (Topeka, KS)
- …**Preferred Qualifications** + Bachelor's Degree - Preferred + More than 3 years of grievance and appeals experience + Strong knowledge in Microsoft Access or ... help us put health first** The Manager, Grievances & Appeals manages client denials and concerns by conducting a...review of clinical documentation to determine if an a grievance , appeal or further request is warranted and then… 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
- Humana (Topeka, KS)
- …Long-Term Services and Supports, Health Information Technology, Enrollment, Member Services, Grievance and Appeals , Claims, Encounters, Program Integrity and ... and growth of the Medicaid and Duals lines of business . This is a unique opportunity for a motivated...to leadership. + Participate in the proposal development process. Provide content and recommendations to help shape responses to… 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