• Provider Grievance and Appeals

    Elevance Health (KS)
    ** Grievance and Appeals Program Manager , Senior** **Location:** Kansas. This position will work a hybrid model (remote and office). The ideal candidate will ... miles of one of our Kansas Elevance Health PulsePoint locations. The ** Grievance and Appeals Program Manager , Senior​** will be responsible for managing… more
    Elevance Health (10/22/24)
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  • Manager , Grievance

    VNS Health (Manhattan, NY)
    …requirements. Also monitors and audits subcontractors who have delegated responsibility for managing grievance and appeals on behalf of the plan to ensure ... collection systems and prepares data reports and analysis of grievance and appeals for program management and...Relations, Claims, Medical Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and… more
    VNS Health (09/04/24)
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  • Grievance / Appeals Analyst I (US)

    Elevance Health (Indianapolis, IN)
    **Title: Grievance / Appeals Analyst 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 Analyst I** is an entry level...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/29/24)
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  • Grievance / Appeals Analyst Lead

    Elevance Health (Richmond, VA)
    **Title: Grievance / Appeals Analyst Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... a California PulsePoint location. The ** Grievance / Appeals Analyst Lead** will be responsible for...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/25/24)
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  • Grievance / Appeals Analyst…

    Elevance Health (Los Angeles, CA)
    **Title: Grievance / Appeals Analyst 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 Analyst I** is an entry level...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/11/24)
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  • Grievance / Appeals Analyst Lead

    Elevance Health (Norfolk, VA)
    ** Grievance / Appeals Analyst Lead** **Candidates must be located within 50 miles of Atlanta, GA, Miami, FL, Mason, OH, Norfolk, VA, Tampa, FL, or Topeka, KS** The ... ** Grievance / Appeals Analyst Lead** is responsible for leading...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/11/24)
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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...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (11/02/24)
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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,...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (11/02/24)
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  • Supervisor, Appeals & Grievances…

    Point32Health (MA)
    …direction of the Senior Manager of Appeals and Grievances the Appeals and Grievance Supervisor, through the use of general knowledge of Plan benefits ... and provide leadership for the daily operations of the Appeals and Grievances department. The Supervisor represents the ...team of Analysts and Coordinators + Work with Senior Manager to ensure that employees have the requisite information… more
    Point32Health (10/09/24)
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  • Fair Hearing Appeals Agent

    Conduent (Hamilton, NJ)
    …and Health Services (DMAHS) of New Jersey. **Reports To** This position reports to the Appeals Supervisor and the Appeals Manager . The Appeals ... individuality is noticed and valued every day. Fair Hearing Appeals Agent $18.50/ Hourly Onsite- Hamilton, NJ Full-time and...assistance for medical services may appeal Fair Hearing or Grievance decisions to which they were denied coverage, or… more
    Conduent (10/09/24)
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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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  • Labor Relations Manager (DOT Executive IV)

    Maryland Department of Transportation (Anne Arundel County, MD)
    …as the delegated representative of the Secretary of Transportation for Second Step grievance appeals and disciplinary action appeals . + Negotiating the ...  Labor Relations Manager (DOT Executive IV) Salary $95,991.00 - $154,928.00 Annually Location Anne Arundel County Job Type Full Time Remote Employment… more
    Maryland Department of Transportation (10/29/24)
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  • Remote Manager Clinical A&G

    Healthfirst (NY)
    …equivalent work experience + RN or LPN + Experience with utilization management or appeals and grievance processing and compliance + Working experience in a ... for expedited cases + Helps standardize and optimize how Appeals and Grievances are routed + Determine best practices...and DSE on educating providers in how to submit Appeals timely and accurately. + Maintains delegated vendor relationship… more
    Healthfirst (09/25/24)
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  • Supervisory Veterans Service Representative…

    Veterans Benefits Administration (Huntington, WV)
    …The Supervisory Veterans Service Representative - Assistant Veterans Service Center Manager (AVSCM) shares in the responsibility of managing Veterans Service Center ... as taking claims and assisting claimants in the preparation of claims, appeals or other documents. Delegates authority to make decisions including determining basic… more
    Veterans Benefits Administration (11/01/24)
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  • Supervisory Veterans Service Rep-Assistant Veteran…

    Veterans Benefits Administration (Winston Salem, NC)
    Summary The Supervisory Veterans Service Representative Assistant Veterans Service Center Manager (AVSCM) shares in the responsibility of managing Veterans Service ... inquiries for approval. Serves as technical advisor to the Service Center Manager and/or Regional Office Director for the administration of Compensation and Pension… more
    Veterans Benefits Administration (11/01/24)
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  • Manager , Team Member Relations- Team…

    Hackensack Meridian Health (Edison, NJ)
    …to transform healthcare and serve as a leader of positive change. The Manager , Regional Team Member Relations reports to the Dir, TM Relations and participates ... of enhancing our overall TM experience. + Serves as the next step for appeals of dispute resolution matters. Supports and collaborates with the Dir, Labor Relations… more
    Hackensack Meridian Health (10/22/24)
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  • Clinical Assessment Manager , UAS Field…

    VNS Health (Nassau, NY)
    …eligibility. + Coordinates with other departments, eg Care Management, Legal Affairs, Grievance and Appeals , Compliance, Membership Eligibility Unit, Quality as ... a Registered Professional Nurse in New York State required + Certified Case Manager preferred Education: + Bachelor's Degree in nursing or equivalent work experience… more
    VNS Health (10/03/24)
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  • Human Resources Analyst C Or Specialist

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …denial, or other actions on new and/or updated position descriptions, appeals for reallocation and related transactions. + Submits requested position description ... pay upon hire etc. Consults with Talent Acquisition staff and/or Human Resources Manager regarding best pay mechanism for action reason. + Serves as Subject Matter… more
    Louisiana Department of State Civil Service (10/26/24)
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  • Senior Medical Director - Sharp Health Plan

    Sharp HealthCare (San Diego, CA)
    …to Plan policy as needed.Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager to identify ... needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'...data of paid claims, encounters, authorization logs, complaint and grievance logs and other sources. + Achieves and maintains… more
    Sharp HealthCare (10/20/24)
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