• Manager , Appeals…

    Molina Healthcare (Kearney, NE)
    …* Manages team responsible for the submission/resolution of member and provider appeals and grievances ; ensures resolutions are compliant with applicable ... call tracking system of correspondence and outcomes for provider and member appeals / grievances ; oversees/monitors appeals to ensure all internal and… more
    Molina Healthcare (11/13/25)
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  • Senior Project Manager , Claims Operations

    Molina Healthcare (Omaha, NE)
    …Design scalable workflows and controls across intake, adjudication, adjustments, appeals / grievances , and payment integrity. + Technology Enablement: Oversee ... understanding of claims lifecycle, EDI transactions, payment integrity, provider data, appeals / grievances , and audit/compliance (CMS, HIPAA, NCQA, state regs). +… more
    Molina Healthcare (10/19/25)
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  • Key DSO Dental Account Manager

    Guardian Life (Lincoln, NE)
    …contact for all assigned DSOs. Respond to provider inquiries, concerns, complaints, appeals and grievances within assigned timeframes. Collaborate across teams ... to Dental Support Organization (DSO) partners. As a **Key DSO Dental Account Manager , Dental Support Organizations** , you will be responsible for growing the… more
    Guardian Life (11/18/25)
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  • Medical Director (NV)

    Molina Healthcare (Omaha, NE)
    …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 investigation of adverse… more
    Molina Healthcare (11/21/25)
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