- Catholic Health Services (Melville, NY)
- …named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... more
- Lincoln Financial Group (Columbus, OH)
- …team of roughly 8-10 Appeals Specialist, Consultants, and Associates. As an Appeals Manager in our Group Protection Claims organization, you will be ... more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization/ appeals management review. | Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... more
- VNS Health (Manhattan, NY)
- …navigating the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the daily operations of our ... more
- New York State Civil Service (Melville, NY)
- …by the Workers' Compensation Law;* Assisting in the assignment of cases when the Appeals Unit Manager is absent for extended periods;* Assisting the Legal ... more
- Point32Health (MA)
- …members, partners, colleagues and communities. **Job Summary** Under the direction of the A&G Manager , the Appeals & Grievances QA Auditor audits the quality of ... more
- Point32Health (MA)
- …colleagues and communities. **Job Summary** SUMMARY Under the general direction of the Senior Manager of Appeals and Grievances the Appeals and Grievance ... more
- CareFirst (Baltimore, MD)
- …educational and training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in the development and ... more
- Walmart (Bentonville, AR)
- …to set new industry standards that shape the future of Walmart. As a Hearing Appeals Manager , you will be a central team member to Walmart Unemployment Services ... more
- UCLA Health (Los Angeles, CA)
- …NCQA, State and Federal regulations with direction from the Medical Director and QM Manager . + Review all member appeals and grievances for accuracy, ensuring ... more
- Centene Corporation (Sacramento, CA)
- …initial and ongoing training in necessary skills and knowledge base and will assist Manager of Grievance and Appeals to establish and maintain procedures for ... more
- Mount Sinai Health System (New York, NY)
- …issues in an accurate and timely fashion. In collaboration with the Underpayment Team manager , the Senior CBO Appeals Analyst will work to further the CBO's ... more
- Rush Copley Medical Center (Aurora, IL)
- …organizing, staffing, coaching, facilitating, and motivating staff members of the Care Management/ Appeals team. This Manager is responsible for the department's ... more
- Novant Health (Charlotte, NC)
- …appeals , campaigns, point of purchase retail roundups, phone-a-thons, electric and written appeals . The annual fund manager is responsible for a year-round ... more
- Point32Health (Canton, MA)
- …and communities. **Job Summary** Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational aspects of ... more
- Hartford HealthCare (Wethersfield, CT)
- …in the current, rapidly changing medical environment. *_Position Summary:_* The Denial and Appeals Nurse is an integral part of the Care Management team. Their focus ... more
- TEKsystems (Sarasota, FL)
- Description 1. Manages workflow for Humana PPI Audits, RAC Audits, or outpatient appeals and communicates daily with Sr. Director/ Manager on trends identified 2. ... 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, 90017 ... more
- Molina Healthcare (Columbus, OH)
- …Monday-Thursday and Wed - Saturday._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for ... 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 ... more
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