• Medicare Grievances

    Humana (Boston, MA)
    …Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
    Humana (06/18/25)
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  • Member Appeals and Grievance Intake Admin…

    Fallon Health (Worcester, MA)
    …of Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Intake Administrator is responsible for triaging and ... be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for...assigning all incoming appeals and grievances more
    Fallon Health (08/01/25)
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