- Molina Healthcare (South Charleston, OH)
- …Manages staff responsible for the submission/resolution of member and provider inquiries, appeals and grievances for the Plan. Ensures resolutions are compliant. ... tracking system of correspondence and outcomes for provider and member appeals / grievances ; oversees monitoring of each member submission/resolution to ensure… more
- Molina Healthcare (Columbus, OH)
- …Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of the Appeals & Grievances unit that is responsible for reviewing and ... or as directed by the Centers for Medicare and Medicaid Services. * Trains grievance and appeals ... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- Molina Healthcare (Akron, OH)
- …to remediate immediate and acute gaps in care and access. Assist members with filing grievances and appeals . + Connects members to CCEs, the Ohio RISE Plan,or ... you will also work on telephonic population health initiatives such as supporting Medicaid members that have a waiver, making outreach to Medicaid members… more
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