- Molina Healthcare (Savannah, GA)
- …**Job Summary** Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and ... Manages staff responsible for the submission/resolution of member and provider inquiries, appeals and grievances for the Plan. Ensures resolutions are compliant. +… more
- Elevance Health (Atlanta, GA)
- **Nurse Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... between those hours, including holidays on a rotational basis. The **Nurse Appeals ** is responsible for investigating and processing and medical necessity appeals… more
- CVS Health (Atlanta, GA)
- …and every day. **Position Summary** Plans and executes strategies to meet the Grievance & Appeals organization's long-range goals. Evaluates and develops new ... initiatives and analyzes business opportunities. Develops proposals, including feasibility studies, for new opportunities. Identifies, analyzes and compares alternative opportunities for solutions and adopting new technologies. + Acts as a top-level specialist… more
- Elevance Health (Atlanta, GA)
- …necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more