• Grievances and Appeals 3

    CenterWell (Augusta, ME)
    **Become a part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by ... trained skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced… more
    CenterWell (10/08/25)
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  • Coordinator, Appeals & Grievances

    Evolent (Augusta, ME)
    …or GED is required. + Minimum of 3 years' experience in an Appeals and Grievances role or comparable administrative role within a health plan, managed ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Appeals and Grievances ** at Evolent is responsible for reviewing and processing case requests,… more
    Evolent (10/11/25)
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  • Appeals Quality and Training Specialist…

    Martin's Point Health Care (Portland, ME)
    …been certified as a "Great Place to Work" since 2015. Position Summary The Appeals Quality and Training Specialist supports the Appeals Department. This role ... goals through quality monitoring and training. This role partners directly with Appeals leadership to support on-going team development and growth. This role creates… more
    Martin's Point Health Care (10/07/25)
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  • Appeals Nurse

    Evolent (Augusta, ME)
    …**Required** + Minimum of 5 years in Utilization Management, health care Appeals , compliance and/or grievances /complaints in a quality improvement environment- ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...to 7pm CST (which includes 30-minute unpaid lunch break) 3 days/week, to meet the business needs of nurses… more
    Evolent (10/11/25)
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  • Registered Nurse - Clinical Appeals…

    Cognizant (Augusta, ME)
    …or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances , precertification, initial and concurrent reviews . ... . Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes.… more
    Cognizant (10/09/25)
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