• QA Auditor : Appeals

    Healthfirst (NY)
    …and Responsibilities:** + Conduct quality audits of A&G items including grievances , pre-service appeals , and post service appeals utilizing appropriate ... to reduce errors and improve processes and performance to ensure quality . + Review and investigate appeals and grievances requests to ensure all requests are… more
    Healthfirst (01/09/25)
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  • Lead, Auditor (RN) Remote

    Molina Healthcare (Mesa, AZ)
    …team responsible monthly auditing of HCS staff. This position will be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with ... previous Appeals and Grievances experience and a clinical...May conduct staff trainings as needed + Communicates with QA supervisor/manager about issues identified and works collaboratively to… more
    Molina Healthcare (01/04/25)
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