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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Trinity Health

Waterbury, Connecticut

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Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic

Houston, Texas

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Providence

Anchorage, Alaska

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Spartanburg Regional Healthcare System

Spartanburg, South Carolina

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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CHRISTUS Health

Lake Charles, Louisiana

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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Kelsey-Seybold Clinic Logo
Kelsey-Seybold Clinic

Houston, Texas

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CHRISTUS Health

Santa fe, New Mexico

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Medical Dr 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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