• Director, Appeals & Grievances…

    Molina Healthcare (Sioux City, IA)
    …apply state level requirements to meet contract and regulatory expectations. * Establishes Appeals & Grievances department policies and procedures in line with ... and interprets trends and prepares reports that identify root causes for Appeals , Grievances , and Provider Disputes. Recommends and implements process… more
    Molina Healthcare (07/20/25)
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  • Director, Appeals & Grievances…

    Molina Healthcare (Des Moines, IA)
    …and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with the standards and requirements established by ... the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes that is responsible for reviewing and... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
    Molina Healthcare (07/18/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (IA)
    …and Marketplace request authorization. Strongly prefer candidates with a background in appeals and grievances . Excellent computer multi-tasking skills and good ... office with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for … more
    Molina Healthcare (08/02/25)
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  • LTSS Service Coordinator

    Elevance Health (West Des Moines, IA)
    …Services, Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. + Travels to worksite and other ... 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
    Elevance Health (07/12/25)
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