• Grievances and Appeals 3

    CenterWell (Santa Fe, NM)
    **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)
    - Related Jobs

  • Medical Director (AZ)

    Molina Healthcare (Las Cruces, NM)
    …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)
    - Related Jobs