- VNS Health (Manhattan, NY)
- …Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and grievances . + Ensures the accuracy and integrity of data ... of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the...Lead with Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long… more
- CVS Health (Richmond, VA)
- …**Position Summary** Coordinate effective resolution of member and/or provider/practitioner appeals , complaints and grievances . Responsible for the day-to-day ... management of staff to ensure effective resolution of member or provider/practitioner appeals , complaints and grievances for all products, which may contain… more
- Medical Mutual of Ohio (OH)
- …new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists ... Specialists in the research and review of Part D and Part B inquiries, grievances , and CTMs, updating tracking documents, audit research items, and marketing… more
- Washington Metropolitan Area Transit Authority (Washington, DC)
- Contract Manager Job ID: 240531 Location: DC - L'Enfant Plaza Full/Part Time: Full-Time Posting Open-Close 10/28/2024 - 11/11/2024 Union NRP Regular/Temporary: ... the National Contract Management Association (NCMA), the Certified Professional Contracts Manager (CPCM) or an appropriate certificate from a program sponsored by… more
- Henry Ford Health System (Detroit, MI)
- GENERAL SUMMARY: Under the direction of the Compliance Audit Manager , the Principal Compliance Investigator will oversee compliance auditing and monitoring to ... all levels of the organization. + Writes and reviews audit programs, audit work papers, and ...Compliance, FDR oversight activities, Quality Management, Care Management, and/or Grievances and Appeals . + Demonstrated experience at… more
- LA Care Health Plan (Los Angeles, CA)
- …care setting. Experience in health care auditing and monitoring (preferably in Appeals , Grievances , Quality Improvement, Utilization Management (UM) and so ... Compliance unit, the Advisor also advises and supports the Manager , Director, and Chief Compliance Officer on other duties...forth) and developing audit tools. Demonstrated experience developing and delivering training programs… more