• Grievances and Appeals 3

    CenterWell (Lansing, MI)
    **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 (10/03/25)
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  • Appeals And Grievance Specialist

    Area Agency On Aging 1-b (Southfield, MI)
    …Appeals and Grievance Specialist is responsible for managing and resolving appeals and grievances in accordance with contractual, regulatory, and ... and Grievance Specialist is responsible for managing and resolving appeals and grievances in accordance with contractual,...to Advanced. OUR INDUSTRY-LEADING BENEFITS CONSISTS OF: Choice of 3 excellent next to zero cost Medical Plans including… more
    Area Agency On Aging 1-b (09/24/25)
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  • Medical Director (AZ)

    Molina Healthcare (MI)
    …reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more
    Molina Healthcare (09/26/25)
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