• Medical Director - IP Claims Management

    Humana (Albany, NY)
    …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, and ... post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled… more
    Humana (12/11/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Buffalo, NY)
    …a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high speed required Work Schedule ... for a RN with experience with appeals, claims review, and medical coding . JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment… more
    Molina Healthcare (11/23/25)
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