- Molina Healthcare (IA)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider ... 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 (West Des Moines, IA)
- **Audit & Reimbursement Senior- Appeals ** **_Location:_** _This role enables associates to work virtually full-time, with the exception of required in-person training ... independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings...report reopenings. + Manage caseload of Medicare cost report Appeals + Position papers + Jurisdictional Reviews + PRRB… more
- Elevance Health (West Des Moines, IA)
- **Audit & Reimbursement II- Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... Perform cost report reopenings. + Under guided supervision, participate in completing appeals related work: + Position papers + Jurisdictional Reviews + Maintaining… more
- Molina Healthcare (Iowa City, IA)
- …may have technical team members. **Expanded Scope:** The Senior Project Manager for Claims Operations drives complex, multi-workstream initiatives that span people, ... Design scalable workflows and controls across intake, adjudication, adjustments, appeals /grievances, and payment integrity. + Technology Enablement: Oversee requirements,… more
- Banner Health (IA)
- …make Banner Health the best place to work and receive care. As an Associate Manager of RN Denials Management, you will be an integral part of leadership within the ... on team members to ensure quality reviews of payer denials and/or appeals . Accurately and thoroughly completes documentation required for claims payment of services… more
- Access Dubuque (Dubuque, IA)
- Clinical Account Manager **MedOne Pharmacy Benefit Solutions** 1 Positions ID: 3543661 Posted On 09/02/2025 Refreshed On 10/07/2025 **Job Overview** **Position ... Overview:** The Clinical Account Manager will support all clinical aspects of the business...process, including communicating clinical rationale, formulary therapeutic alternatives, and appeals process to members + Performs duties related to… more
- Ralliant (Des Moines, IA)
- **Job Title:** Product Manager **Location:** Remote, USA **Job Summary:** As a key contributor within Hengstler-Dynapar, the **Product Manager ** will guide the ... aligns with the company's business objectives while collaborating cross-functionally. The Product Manager will work closely with all functions within our company to… more
- CVS Health (Des Moines, IA)
- …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 to develop strategic… more
- Cardinal Health (Des Moines, IA)
- …services. . Help patients understand insurance coverage, out-of-pocket costs, and appeals processes. . Assist in obtaining insurance, prior authorization, and appeal ... requirements and outcomes. . Remain knowledgeable about changes in the reimbursement environment (Medicare, Medicaid, Managed Care, Commercial plans). **Program Expertise & Continuous Improvement** . Remain updated on available patient resources and oversee… more
- Access Dubuque (Dubuque, IA)
- …philanthropic support. The Advancement Officer will oversee all annual giving appeals , including membership, and will be responsible for developing and implementing ... that prioritizes streamlined donor and member communications, employs targeted annual appeals and drives, and identifies opportunities for strategic events +… more