Corporate Medical Director - Medicare Grievances and Appeals (32-Hours…
Humana- Full Time
- Senior (5 to 8 years)
Candidates must be Board Certified in Pathology and hold an active medical license. They are required to have experience conducting detailed reviews of medical records pertaining to pathology to address client inquiries using appropriate criteria and guidelines, and to ensure that determinations are clear, concise, and supported by sufficient documentation. Maintaining active licensure and certifications is also a requirement, as is engagement in mandatory training and orientation sessions.
As a Physician Advisor for Disability Peer Review, the role involves leveraging expertise in pathology to review cases and provide expert opinions on the medical necessity of treatments and claims, ensuring adherence to client-specific policies and nationally recognized standards of care. The Physician Reviewer will conduct reviews of medical records, identify and apply clinical guidelines, provide timely reports, complete reviews by deadlines, perform follow-up communications, and participate in quality assurance issues and audits as necessary.
Specialty coffee shop with efficient service
Blank Street provides a unique coffee shop experience by offering high-quality coffee and food at affordable prices. The company started with a small coffee cart in Brooklyn and has since expanded to major cities like New York, London, Boston, and Washington, D.C. Their product offerings include specialty coffees sourced from around the world and fresh, locally-sourced food. Customers can enjoy a quick yet premium experience, thanks to the efficiency of their small locations that help keep costs down. Blank Street differentiates itself from competitors by focusing on customer convenience through technology, such as their app that allows for ordering ahead, customizing drinks, and participating in loyalty programs. They also prioritize employee satisfaction by paying baristas above-market wages. The goal of Blank Street is to redefine the coffee shop experience by combining quality, affordability, and exceptional service, making it a significant player in the specialty coffee market.