• Director, Home Health Grievances…

    CenterWell (Frankfort, KY)
    …the Denials Management data analytics, denial and appeal process. The Director, Home Health Grievances & Appeals assists members, via phone or face to face, ... and clinical policy development/implementation required + Expert knowledge of all Medicare regulations and appeals processes + Excellent analytical skills… more
    CenterWell (01/08/26)
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  • Grievances and Appeals…

    Humana (Frankfort, KY)
    …part of our caring community and help us put health first** The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of ... of variable factors and determining the best course of action. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness… more
    Humana (01/01/26)
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  • National Contracting Director (Large Hospital…

    Molina Healthcare (Lexington, KY)
    …Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances . * Coordinates with Corporate and Business Development teams to ... reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate , Legal and other stakeholders regarding new reimbursement models… more
    Molina Healthcare (01/11/26)
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