- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical) is responsible… more
- 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
- Elevance Health (Mason, OH)
- **Nurse Appeals -Licensed Nurse** **Location** : Ohio, candidates must be residents of Ohio to be considered. **Hybrid 1** : This role requires associates to be ... will be necessary and is dependent on court hearing schedules. The Nurse Appeals is responsible for investigating and processing and medical necessity appeals … more
- Elevance Health (Tampa, FL)
- **Nurse Appeals ** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law._ The **Nurse Appeals ** is responsible for investigating and processing and medical necessity appeals… more
- Elevance Health (Tampa, FL)
- …for system edits. + Coordinates research and responds to system inquiries and appeals . + Conducts research of claims systems and system edits to identify ... reviews to ensure proper coding was used. + Prepares correspondence to providers regarding coding and fee schedule updates....Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- State of Colorado (Colorado Springs, CO)
- …(Health Professional VI) - Therapeutic Community Program Manager (Hybrid) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5154145) Apply CDOC ... (Health Professional VI) - Therapeutic Community Program Manager (Hybrid) Salary $7,971.00 - $11,159.00 Monthly Location Colorado...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- City and County of San Francisco (San Francisco, CA)
- …managing the operations of the general services units, and in that manager 's absence, has full responsibility for coordinating, and implementing program planning and ... controls are maintained. + Assist Custodial Director in drafting memo correspondence to communicate custodial performance, staffing updates, and service concerns to… more
- State of Colorado (Colorado Springs, CO)
- Client Manager /Parole Officer - Youth Service Counselor II - Southern Region Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5152457) Apply ... Client Manager /Parole Officer - Youth Service Counselor II - Southern...the importance of language, professionalism, and confidentiality in all correspondence . Parole Planning and Supervision: + Facilitate pre-parole staffing.… more
- Fallon Health (Worcester, MA)
- …those correspondence to providers. + Filing of individual provider appeals files in accordance with department standards. Maintain provider appeal database and ... on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with… more
- State of Colorado (Colorado Springs, CO)
- ADMINISTRATOR IV: Clinical Contracts Manager (Colorado Springs, Colorado) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5167059) Apply ... ADMINISTRATOR IV: Clinical Contracts Manager (Colorado Springs, Colorado) Salary $5,962.00 - $9,541.00 Monthly...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Grand Junction, CO)
- Pavement Manager - Resident Engineer (PE I)- Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5162844) Apply Pavement Manager - Resident ... meetings, as well as monthly status meetings. + Serve as pre-construction project manager for assigned projects, setting up and managing the PDP (Project Development… more
- State of Colorado (CO)
- …Only - Division of Local Government - Regional Manager - (Reallocation) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5170872) Apply DOLA ... Only - Division of Local Government - Regional Manager - (Reallocation) Salary $10,800.00 - $11,163.00 Monthly Location Statewide, CO Job Type Full Time Job Number… more
- State of Colorado (CO)
- DOLA - BoS HMIS Manager (Administrator V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5163020) Apply DOLA - BoS HMIS Manager ... as a critical bridge to the HMIS team ensuring aligned operations. The HMIS Manager is responsible for the Balance of State Continuum of Care's portion of COHMIS,… more
- City of New York (New York, NY)
- …ARE PERMANENT (NOT PROVISIONAL) IN THE CIVIL SERVICE TITLE CONSTRUCTION PROJECT MANAGER . About the Agency: The Administration for Children's Services (ACS) protects ... seeks qualified applicants for the position of Construction Project Manager to play a critical role in the Planning,...computer systems to manage files, generate reports, and produce correspondence - Investigate and advise on contract disputes and… more
- City of New York (New York, NY)
- …and progress. Uses computers to maintain files and generate reports, correspondence , and other paperwork. - Investigates and advises the agency concerning ... contract disputes, and appeals on the rejection of equipment, materials, or workmanship;...community and members of the public. Prepares reports and correspondence for approval in dealings with contractors and the… more
- Sharp HealthCare (San Diego, CA)
- …**Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered ... Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Bachelor's Degree in Nursing; Master's… more
- Transdev (Dorchester, MA)
- Overview: Transdev in Boston, MA is seeking a Labor Relations Manager for its Boston Public Schools transportation contract. The Labor Relations Manager provides ... + Manage labor relations program of the property jointly with the General Manager . + Research, compile, and prepare data for use in grievance hearings, arbitration… more
- The County of Los Angeles (Los Angeles, CA)
- …quality assessment and assurance monitoring processes; and handle informal complainant appeals . Health Facilities Program Manager , Nursing positions are required ... HEALTH FACILITIES PROGRAM MANAGER , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4626091) Apply HEALTH FACILITIES PROGRAM MANAGER… more
- Houston Methodist (Katy, TX)
- At Houston Methodist, the Manager Revenue Cycle position is responsible for the daily management of the staff and operations for one or more of the following areas ... to: medical coding, insurance billing, collections, patient account resolution, appeals /denials, customer service, cash applications, revenue integrity, etc. This… more
- 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