- Apex Health Solutions (Houston, TX)
- Summary: The Appeals and Grievances coordinator, Senior position, is focused on the processing of customer and provider Medicare and Commercial appeals ... cost efficiency and a commitment to the Continuous Quality Improvement Process. The Appeals & Grievance Coordinator, Senior , will interact on a daily basis… more
- Health First (Melbourne, FL)
- …Health Plans (Health Insurance)* **Organization:** **HF Administrative Plan Inc* **Title:** * Manager Complaints, Grievances , and Appeals * **Location:** ... to resolve internal operational issues that may cause increase to member appeals / grievances volumes and drive operational efficiencies. 10. Maintain technical… more
- Highmark Health (Pittsburgh, PA)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Senior Product Manager , Claims will define the product strategy, vision, and value ... for members, improving payment integrity, and optimizing the experience of denials, appeals , and grievances . The ideal candidate outlines the strategic vision… more
- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have ... and related filings, new benefit implementation, and product/vendor management processes. The Senior Manager will support annual assessment of new product… 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 ... new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists… more
- Sharp HealthCare (San Diego, CA)
- …as needed.Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight...needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'… more
- Sacramento County (Sacramento, CA)
- …* Current recruitment includes, but is not limited to, the following position: Senior and Adult Services Human Services Division Manager . Click here ... Human Services Division Manager Range A/B Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2234944) Apply Human Services Division Manager … more
- Sacramento County (Sacramento, CA)
- Human Services Program Manager Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2751183) Apply Human Services Program Manager Salary ... 12/4/2024, 12/18/2024 (Final) Under direction, the Human Services Program Manager plans, coordinates and manages the work of a...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …, and complaints, refers complex matters to HR Employee Relations Specialist or Senior Manager of Employee Relations as required + Participates in training ... generalist work with 75+% time committed to handling employee complaints, grievances , interactive processes, and disciplinary actions. + Experience with case… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …general knowledge of Federal personnel administration policies and practices including appeals and grievances , Labor Relations, Employee Relations, Position ... the Office of the Director and assist the EEO Manager in planning, development, implementation, evaluation, and monitoring the...new or revised policies and procedures in EEO. Brief senior leaders, managers, and supervisors on EEO mission, goals,… more
- Veterans Affairs, Veterans Health Administration (Honolulu, HI)
- …organization and distribution or functions, staffing activities and organizational structure. Senior Program Manager : Plan, schedule, and carry out major ... staff; coordinating and participating in disciplinary actions and responding to appeals and grievances ; developing, implementing, and evaluating procedures… more
- Securities and Exchange Commission (Chicago, IL)
- Summary You will serve as a senior trial attorney and manager , providing program direction and technical leadership in the CHRO. As an expert in a specialized ... presentation of matters to a federal grand jury, criminal trials, and appeals . Advises SEC executive management with regard to legal strategy. Exercises a… 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 ... for the Regulatory Compliance unit, the Advisor also advises and supports the Manager , Director, and Chief Compliance Officer on other duties as assigned to support… more
- VNS Health (Manhattan, NY)
- …the administration of all BH QM/UM and performance improvement activities, encompassing grievances and appeals , and contributes to various other subcommittees ... leadership and medical director meetings as stipulated by the State BH contract manager . Serves as the principal behavioral health/social care expert and liaison for… more