• Corporate Medical Director…

    Humana (St. Paul, MN)
    …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
    Humana (09/05/25)
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  • Medical Director - Medicare…

    Humana (St. Paul, MN)
    …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
    Humana (09/06/25)
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  • Appeals and Grievances Clinical Specialist…

    Healthfirst (MN)
    …productivity and quality for each Specialist against expectations + Prepare cases for Medical Director Review ensuring that all pertinent information (ie case ... of clinical cases, such as: Pre-existing Conditions, Prior Approval, Medical Necessity, Pre-certification, Continued Stay, Reduction, Termination, and Suspension of… more
    Healthfirst (09/09/25)
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  • Manager of Volunteer Services

    St Croix Hospice (Mendota Heights, MN)
    …the volunteer program in in compliance with agency policy and procedure. Meets Medicare and NHPCOs standards for compliance and agency goals. + Maintains and follows ... and family/caregiver and entire hospice team. + Reports all grievances / complaints made by patients and families to...complaints made by patients and families to the Regional Director of Clinical Operations and assists with follow up.… more
    St Croix Hospice (08/27/25)
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