- AmeriHealth Caritas (Philadelphia, PA)
- …more about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances , this position is responsible for the ... more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... more
- LA Care Health Plan (Los Angeles, CA)
- Appeals & Grievances Regulatory Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... more
- Point32Health (MA)
- …and communities. **Job Summary** Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational ... more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... more
- Point32Health (MA)
- …colleagues and communities. **Job Summary** Under the direction of the A&G Manager, the Appeals & Grievances QA Auditor audits the quality of letters and keyed ... more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... more
- Point32Health (MA)
- …**Job Summary** SUMMARY Under the general direction of the Senior Manager of Appeals and Grievances the Appeals and Grievance Supervisor, through ... more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... more
- Healthfirst (AL)
- …-QOC experience preferred + Experience in clinical practice with experience in appeals & grievances , claims processing, utilization review or utilization ... more
- UCLA Health (Los Angeles, CA)
- …the primary point of contact for receipt of member-initiated complaints and Health Plan grievances and appeals . The Grievance and Appeals Intake Coordinator ... more
- Healthfirst (NY)
- **Duties and Responsibilities:** + Conduct quality audits of A&G items including grievances , pre-service appeals , and post service appeals utilizing ... more
- VNS Health (Manhattan, NY)
- …opportunity to: * Lead with Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long Term Care (MLTC), Medicare ... more
- Centene Corporation (Tallahassee, FL)
- …load. + Ensure that the Appeals & Grievance department processes all appeals , grievances and complaints in accordance with standards and the corporation's ... more
- CDPHP (Albany, NY)
- …This individual will be responsible for tracking, trending and monitoring of appeals , grievances , NYS external review, and making recommendations for change. ... more
- CDPHP (Albany, NY)
- … Appeals Coordinator is responsible for the timely and accurate triaging all appeals , grievances , and complaints that come in to the department, and working ... more
- Centene Corporation (Phoenix, AZ)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... more
- Point32Health (Canton, MA)
- …responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for ... more
- Point32Health (MA)
- …and communities. **Job Summary** Under general direction of the Supervisor of Member Appeals and Grievances , the primary function of the Sr. Analyst is ... more
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