• Medicare Grievances

    Humana (Raleigh, NC)
    …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 (10/29/24)
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  • Appeals Analyst

    Motion Recruitment Partners (Durham, NC)
    …Be Doing** + Analyze, research, resolve and respond to confidential/sensitive appeals , grievances and coverage/organization determinations from members, member's ... review organizations, benefit panels and external medical consultants. + Provide comprehensive appeals and grievances responses that support the decision and… more
    Motion Recruitment Partners (11/12/24)
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