• HFHP Appeals /Grievance Coordinator

    Health First (Rockledge, FL)
    …**Organization:** **HF Administrative Plan Inc* **Title:** *HFHP Appeals /Grievance Coordinator - Member Appeals Grievances * **Location:** *Florida ... - Brevard County-Rockledge* **Requisition ID:** *075564* more
    Health First (11/01/24)
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  • Pharmacy Coordinator ( Appeals )

    Centene Corporation (Tallahassee, FL)
    …offering competitive benefits including a fresh perspective on workplace flexibility. Pharmacy Coordinator - ( Grievances , Appeals , and Prior Authorizations) ... the candidate is hired, based on business need. Job specific responsibilities: + Grievances , Appeals , and Prior Authorizations + Processing Pharmacy Appeals more
    Centene Corporation (10/18/24)
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  • Grievance & Appeals Coordinator

    Elevance Health (Meridian, ID)
    Appeals Coordinator ** is responsible for investigating and reviewing customer grievances and appeals regarding provision of service and benefit coverage ... **Title: Grievance & Appeals Coordinator ** **Location:** This position will...issues. Triages clinical and non-clinical inquiries, grievances and appeals , prepares case files for… more
    Elevance Health (11/02/24)
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  • Grievance and Appeals Coordinator

    Centers Plan for Healthy Living (Staten Island, NY)
    …integral part of the Grievance and Appeals (G&A) Department, the G&A Coordinator lends their support in processing member-related grievances and appeals ... Grievance and Appeals Coordinator 75 Vanderbilt Ave, Staten...RESPONSIBILITIES: + Logs and tracks verbal or written member grievances and appeals . + Conducts relevant research… more
    Centers Plan for Healthy Living (10/11/24)
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  • Grievance & Appeals Coordinator I

    Centene Corporation (Springfield, IL)
    …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and appeals + Maintain files on… more
    Centene Corporation (11/02/24)
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  • Appeals Coordinator

    Brighton Health Plan Solutions, LLC (New York, NY)
    …Health Plan Solutions (BHPS) is seeking an experienced Appeals Coordinator skilled in investigating and resolving grievances , provider payment disputes ... ancillary claims. + Provide accurate and timely responses to appeals , grievances and all other correspondence. + Communicate effectively with individuals/teams… more
    Brighton Health Plan Solutions, LLC (10/10/24)
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  • Appeals & Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    **Why This Role is Important to Us:** Appeals and Grievances Representative supports the Operations Department and the Appeals and Grievances team in a ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with...dental, reporting, and member services. - Supports the Senior Appeals & Grievance Coordinator and A/G … more
    Commonwealth Care Alliance (09/07/24)
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  • Medicare Pharmacy Coordinator

    Medical Mutual of Ohio (OH)
    …new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists ... new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists… more
    Medical Mutual of Ohio (09/20/24)
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  • Appeal and Grievance Coordinator - MUST…

    CVS Health (Richmond, VA)
    …and affordable. **Position Summary** Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
    CVS Health (11/03/24)
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  • LTSS Concierge Coordinator - Kansas

    Elevance Health (Overland Park, KS)
    …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals and state audits. **Minimum Requirements:** + Requires BA/BS ... candidates must be located in the state of Kansas.** The **LTSS CONCIERGE COORDINATOR ** is responsible for supporting the LTSS Coordinator (or contracted… more
    Elevance Health (09/11/24)
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  • LTSS Service Coordinator - Case Manager

    Elevance Health (Jacksonville, FL)
    …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... $5,000 Sign On Bonus **LTSS Service Coordinator ** _Location:_ This is primarily a field based...Polk, Orange, or Palm Beach county. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
    Elevance Health (10/26/24)
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  • LTSS Service Coordinator

    Elevance Health (Woodbridge, NJ)
    …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator ** _Location:_ This is a hybrid role. Candidate...Morristown) at least once a week. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
    Elevance Health (10/11/24)
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  • Cdoc - Program Assistant I (Colorado Springs)

    State of Colorado (Colorado Springs, CO)
    …and submits unemployment claim requests; creates and maintains files for all grievances , State Personnel Board appeals , director's reviews, R6-10, and R5-6 ... notices of R6-10, corrective actions, disciplinary actions, administrative separations, appeals , grievances , 1450-05 reports, termination letters; distribute… more
    State of Colorado (11/01/24)
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  • Human Resources Business Partner- Work Lead

    State of Colorado (Denver, CO)
    …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... retention; selection and selection appeals ; settlement advice; strategic planning and overall HR guidance...this position, please direct your inquiries to our ADAAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more
    State of Colorado (10/25/24)
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  • DNR EDO Employee and Labor Relations Specialist II

    State of Colorado (Denver, CO)
    …to employee relations and providing analysis of potential risk (legal liability, appeals , grievances ) to the delegated staff authority for employee relations. ... in mediation and resolution of employee disputes, performance appraisals, grievances , and crafting corrective actions. + Advises employees and supervisors… more
    State of Colorado (11/01/24)
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  • Correctional, Youth, Security Supervisor III…

    State of Colorado (Golden, CO)
    …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (11/02/24)
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  • Behavioral Services Site Director - Health…

    State of Colorado (Jefferson County, CO)
    …actions; signing performance plans and appraisals and resolving informal grievances . Position starts the hiring process, interviews applicants and hires, ... actions, signing performance plans and appraisals, and resolving informal grievances . This position initiates the hiring process, interviews applicants, and… more
    State of Colorado (10/31/24)
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  • Licensing and Designation Manager- Remote

    State of Colorado (Grand Junction, CO)
    …designation activities on behalf of the BHA and receives and investigates grievances submitted to the BHA through complaints and critical incident reporting. Summary ... or adverse action documents; and communicating/corresponding with those who submit grievances and licensed agencies. + Evaluate programs through the analysis of… more
    State of Colorado (10/29/24)
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  • Correctional Youth Security Officer II -Aspire…

    State of Colorado (Golden, CO)
    …+ Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, follow up and appropriate action Shift Supervision + ... facility and throughout CYSOs + Functions as the training Coordinator for the facility. Train staff in DYS Policy...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (10/31/24)
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