- CVS Health (Downers Grove, IL)
- …obtain crucial or required information from Providers, such as HEDIS, Revalidation, Grievance and Appeals , SIU, etc. Coordinate provider status information with ... Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals & Disputes and/or Network Performance Standards * Progressive leadership… more
- Elevance Health (Chicago, IL)
- …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