- Point32Health (TX)
- …general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for… more
- Elevance Health (Harrisburg, PA)
- …of clinical information. + The analyst may serve as a liaison between grievances & and appeals and /or medical management, legal, and/or service operations, ... Department that reviews analyzes and processes non-complex pre-service and post-service grievances and appeals requests from customer types (ie member,… more
- City and County of San Francisco (San Francisco, CA)
- …bargaining agreements. + Key duties include negotiating resolutions to grievances , investigating complaints of serious employee misconduct, and conferring with ... professional human resources experience, similar to 1241 Human Resources Analyst , in one or more of the following areas...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- LA Care Health Plan (Los Angeles, CA)
- …assurance (especially related to claims, health services/population health as well as appeals and grievances systems, applications, etc.) Knowledge of and ... Quality Configuration Assurance Analyst III Job Category: Information Technology Department: IT...(including but not limited to, claims processing, population health, appeals and grievances , etc.) and the systems… more
- LA Care Health Plan (Los Angeles, CA)
- …Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and Grievances : This position requires work after ... Business Analyst III Job Category: Accounting/Finance Department: Encounters Location:...required to achieve that purpose. Job Summary The Business Analyst III facilitates business process improvement via the methodical… more
- State of Colorado (Denver, CO)
- Associate Operations Director ( Analyst VII) - Division of Housing Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4790295) Apply Associate ... Operations Director ( Analyst VII) - Division of Housing Salary $8,637.00 -...corrective or disciplinary action if necessary and resolving informal grievances . Position will start the hiring process, interview applicants,… more
- LA Care Health Plan (Los Angeles, CA)
- Regulatory Compliance Quality Audit Specialist Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... call documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This… more
- Corewell Health (Grand Rapids, MI)
- …all steps of the member grievance. Thoroughly investigate member grievances , leveraging critical thinking skills, gathering relevant information from enterprise-wide ... compliance to all state, federal and accrediting organization requirements. The Grievance Analyst makes decisions on moderately complex issues and work is performed… more
- State of Colorado (Denver, CO)
- …service provision; developing cooperative agreements with local community agencies; mediate appeals and grievances ; project the long-range needs for the ... and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, atspb.colorado.gov/board-rules. Supplemental Information For questions regarding… more