• Manager , Grievance and Appeals , RN

    VNS Health (Manhattan, NY)
    …to, Provider Relations, Claims, Medical Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and grievances. + Ensures ... to day activities for staff handling of grievances and appeals for one of the following VNS Health Plans...have been implemented. + Prepares and disseminates reports and correspondence to enrollees, providers, regulatory entities and program staff… more
    VNS Health (09/04/24)
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  • Appeals Manager , Department…

    BronxCare Health System (Bronx, NY)
    …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
    BronxCare Health System (09/18/24)
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  • Appeals Referee

    Commonwealth of Pennsylvania (PA)
    …that facilitate the appeals process. You will also communicate with the Appeals Referee Program Manager , UCBR headquarters, and other agency staff and draft ... Appeals Referee Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4709711) Apply  Appeals...where you gained this experience + The type(s) of correspondence you prepared + The actual duties you performed… more
    Commonwealth of Pennsylvania (10/31/24)
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  • Grievance & Appeals Coordinator

    Elevance Health (Meridian, ID)
    **Title: Grievance & Appeals Coordinator** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... one of our PulsePoint locations. The **Grievance & Appeals Coordinator** is responsible for investigating and reviewing customer grievances and appeals regarding… more
    Elevance Health (11/02/24)
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  • Nurse Appeals (RN)

    Elevance Health (Los Angeles, CA)
    **Nurse Appeals - Licensed RN Nurse** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the state of ... locations. **Shift:** Monday to Friday from 8:00am-5:00pm PST The **Nurse Appeals ** is responsible for investigating and processing medical necessity appeals more
    Elevance Health (11/02/24)
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  • Medicare Appeals Processing Senior…

    The Cigna Group (Bloomfield, CT)
    …Proactively communicates with appellants, leadership team, providers and the original case manager to resolve investigation issues and to ensure the appeal is ... limited to:** + Ability to differentiate different types of requests Appeals , Grievances, coverage determination and Organization Determinations in order to ensure… more
    The Cigna Group (11/04/24)
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  • Grievance/ Appeals Representative I

    Elevance Health (Meridian, ID)
    **Title: Grievance/ Appeals Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... one of our PulsePoint locations. The **Grievance/ Appeals Representative I** is responsible for reviewing, analyzing and processing claims in accordance with policies… more
    Elevance Health (11/02/24)
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  • FOIA Program Manager

    GAP Solutions Inc (Rockville, MD)
    …appropriateness of the release and review and make recommendations regarding appeals . + Independently process FOIA requests, including correspondence , memoranda, ... Position Objective: Provide services as a FOIA Program Manager in support of the overall functions of the Office of the Director (OD), Office of Science Management… more
    GAP Solutions Inc (10/24/24)
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  • RN Clinical Provider Post Service Review…

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …140 associates. It encompasses a member and provider call center, provider correspondence and appeals , clinical review, member correspondence and ... Position Summary: The RN Clinical Provider Post Service Review Manager , led by a Registered Nurse, is responsible...Registered Nurse, is responsible for a team of provider correspondence associates who research and respond to provider inquires… more
    Blue Cross Blue Shield of Massachusetts (10/23/24)
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  • CDOC - (Social Work/Counselor IV) Drug & Alcohol…

    State of Colorado (Sterling, CO)
    …Work/Counselor IV) Drug & Alcohol Therapeutic Community Manager - Sterling Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4564859) Apply  CDOC ... - (Social Work/Counselor IV) Drug & Alcohol Therapeutic Community Manager - Sterling Salary $7,087.00 - $9,922.00 Monthly Location...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (10/19/24)
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  • DFPC Multi-Mission Aircraft (MMA) Manager

    State of Colorado (Centennial, CO)
    DFPC Multi-Mission Aircraft (MMA) Manager Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4713519) Apply  DFPC Multi-Mission Aircraft (MMA) ... Manager Salary $68,508.00 - $82,224.00 Annually Location Centennial, CO...Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel… more
    State of Colorado (11/01/24)
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  • Colorado State Patrol Communications Regional…

    State of Colorado (Montrose, CO)
    Colorado State Patrol Communications Regional Manager Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4701743) Apply  Colorado State Patrol ... Communications Regional Manager Salary $89,520.00 - $143,256.00 Annually Location Montrose, CO...Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel… more
    State of Colorado (10/23/24)
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  • Manager Of Accounting Services

    Clark County, NV (Las Vegas, NV)
    MANAGER OF ACCOUNTING SERVICES Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4668751) Apply  MANAGER OF ACCOUNTING SERVICES Salary ... Finance, Comptroller Office, is seeking qualified candidates to apply for the Manager of Accounting Services position. This position will be responsible for… more
    Clark County, NV (10/29/24)
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  • Cdoc - Program Assistant I (Colorado Springs)

    State of Colorado (Colorado Springs, CO)
    …monitors, tracks and distributes from the ERU inbox; prepares correspondence , places proper litigation holds, coordinates discovery requests, gathers legal ... and maintains files for all grievances, State Personnel Board appeals , director's reviews, R6-10, and R5-6 meetings, as well...establish an eligible list for referral to the hiring manager for final consideration. Be sure the "Work Experience"… more
    State of Colorado (11/01/24)
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  • Region IV Manager

    State of Colorado (Grand Junction, CO)
    Region IV Manager Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4690984) Apply  Region IV Manager Salary $89,520.00 - $102,960.00 ... posting may be used to fill additional vacancies. Email Address: All correspondence regarding your status in the selection/examination process will be conducted via… more
    State of Colorado (10/26/24)
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  • Planning Grants Unit Manager

    State of Colorado (CO)
    Planning Grants Unit Manager Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4701985) Apply  Planning Grants Unit Manager Salary $89,520.00 ... programs to ensure all deadlines and reporting deliverables are met. + As a manager , this position will serve as a subject matter expert for local government grant… more
    State of Colorado (10/23/24)
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  • Housing and Transit Grant Manager

    State of Colorado (CO)
    Housing and Transit Grant Manager Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4701986) Apply  Housing and Transit Grant Manager Salary ... order to establish an eligible list for referral to the hiring manager for final consideration. Supplemental Information Supplemental Information The State of… more
    State of Colorado (10/23/24)
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  • Administrative Rules Program Manager

    State of Colorado (Denver, CO)
    Administrative Rules Program Manager (Hybrid) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4702503) Apply  Administrative Rules Program ... Manager (Hybrid) Salary $70,140.00 - $86,000.00 Annually Location Denver Metro, CO Job Type Full Time Job Number VAA00115 - 10/24 Department Department of State… more
    State of Colorado (11/01/24)
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  • Real Estate Appraiser I, II, or III

    City of Norfolk, Virginia (Norfolk, VA)
    …process and appraisals to property owners, analyzes information presented during appeals of value, and resolves conflicts through discussion. The incumbent may ... equity, and accuracy. + Explains appraisals to property owners and defends appeals as needed. + Reviews properties receiving tax exemptions to determine eligibility… more
    City of Norfolk, Virginia (11/01/24)
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  • Case Manager I -Transition Planning -Sharp…

    Sharp HealthCare (La Mesa, CA)
    …**Shift End Time** Master's Degree; Bachelor's Degree in Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Certified Case ... Manager (CCM) - Commission for Case Manager ...timely delivery of regulatory and mandated patient communications and correspondence .The RN CM I oversees preparation, delivery and documentation… more
    Sharp HealthCare (10/04/24)
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