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Arkansas Colleges of Health Education

Fort Smith, Arkansas

Arkansas Colleges of Health Education

Fort Smith, Arkansas

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

Touro College of Osteopathic Medicine - Montana Logo
Touro College of Osteopathic Medicine - Montana

Great Falls, Montana

The New York Institute of Technology

Jonesboro, Arkansas

Arkansas Colleges of Health Education

Fort Smith, Arkansas

St. Claire HealthCare

Morehead, Kentucky

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The Guthrie Clinic

Corning, New York

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Carle Health

Urbana, Illinois

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Southern California Permanente Medical Group

Fontana, California

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Southern California Permanente Medical Group

Ontario, California

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Kaiser Permanente - Washington Permanente Medical Group

Tacoma, Washington

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Indiana University Health

Muncie, Indiana

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Medical Director Appeals Grievances
JOB SUMMARYThe Medical Director, Appeals and Grievances provides leadership for Community Health Choice medical management programs. This includes reviewing appeals of adverse determinations, tracking them and providing feedback to Medical Affairs on current overturn trends. In addition will provide clinical input and oversight for Care (Disease) Management, Quality Improvement, Credentialing, and Preventive Health programs. Will work with Provider Relations to maintain and improve relationships with the provider community especially with Value based arrangements. Will perform medical necessity reviews as assigned including reviews with peer-to- peer interactions as needed and other duties as assigned.


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