- Fresenius Medical Care (Phoenix, AZ)
- …support services that are available. Reviews patient rights and responsibilities, grievance information (company and network) and other facilities policies with ... Admission and Continuity of Care Reviews Patient Rights and Responsibilities, Grievance Procedure & Important Numbers Handout, FKC Non-discrimination policy, DNR… more
- UTMB Health (Galveston, TX)
- …action. Provides advice and guidance to managers regarding the employee grievance and appeals processes. Administers, interprets, communicates, and leads training ... regarding various human resources policies, procedures, federal and state employment laws, and initiatives that impact the work environment to management and employees. Serves as the employee relations expert to HR Business Partners and other HR colleagues.… more
- Mount Sinai Health System (Manhattan, NY)
- …of residents' performance and provide feedback. . Ensure compliance with institutional grievance and due process procedures. . Provide verification of education for ... all residents, including those who leave the program prior to completion. . Implement policies and procedures consistent with the institutional and program requirements for resident duty hours and the working environment, including moonlighting, distribution… more
- Point32Health (FL)
- …. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible per State ... and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works collaboratively with… more
- Elevance Health (Cerritos, CA)
- **Title: Grievance /Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law._ The ** Grievance /Appeals Analyst I** is an entry level position in...I** is an entry level position in the Enterprise Grievance & Appeals Department that reviews, analyzes and processes… more
- Elevance Health (Mason, OH)
- **Manager II Grievance /Appeals-RN** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Hills ( _Must be within commutable distance to one of the listed ... is granted as required by law._ The **Manager II Grievance /Appeals** is responsible for management oversight of grievances and...may include, but are not limited to: + Coordinates Grievance and Appeals Committee Meetings and Member Panel Hearings.… more
- CoreCivic (Mason, TN)
- …and a responsibility to better the public good. We are currently seeking a ** Grievance Coordinator** who has a passion for providing the highest quality care in an ... to making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures that both… more
- Elevance Health (Mason, OH)
- …recommendations to uphold or deny appeals; and ensuring all grievance processes are completed within regulatory timeframes. **Minimum Requirements:** .Requires ... proceedings, and/or paralegal experience is strongly desired. .Understanding of the grievance and appeals process is strongly preferred. .Basic knowledge of Medicare… more
- Centene Corporation (Harrisburg, PA)
- …Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals Committee + Support the pay-for-performance programs, including data ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals, claims, related managed care experience, or relevant experience.… more
- CVS Health (Columbus, OH)
- …And we do it all with heart, each and every day. **Position Summary** Enter grievance and appeals cases into the G&A system to launch the case for research and ... Working knowledge of problem solving and decision making skills. - Grievance and appeals experience. **Preferred Qualifications** Health Insurance Call Center… more
- Henry Ford Health System (Troy, MI)
- …to new employees as part of their onboarding to the Appeal and Grievance Team. + Perform other related duties as assigned. EDUCATION/EXPERIENCE REQUIRED: + Associate ... degree in healthcare or a related field. + Minimum of three (3) years of experience in a Customer Service or Provider Inquiry call center; reviewing member contracts, authorizations, and benefits. + Minimum of two (2) years of experience reviewing Claims. +… more
- State of Indiana (Rockville, IN)
- Grievance Speciaist Date Posted: Dec 10, 2025 Requisition ID: 468850 Location: Rockville, IN, US, 47872 Work for Indiana Begin a fulfilling career with the State of ... Indiana by joining one of the largest employers in the state, offering a range of opportunities across 60+ agencies. At the state, you'll find competitive compensation, a robust benefits package and a commitment to work-life balance. Most importantly, you'll… more
- Texas Health Resources (Arlington, TX)
- …most recent experience in healthcare risk management, patient safety, grievance coordination and/or quality with proven experience leading (facilitating) ... required and * 3 years Patient safety or patient grievance management with deployment of effective and reliable processes...You Will Do This position will oversee the patient grievance process, support the entity personnel managing the events… more
- Highmark Health (Natrona Heights, PA)
- …oversight and enhancement of all Service Excellence efforts including complaint, grievance , and internal investigations of patient and family concerns. Duties ... service recovery and resolution of complaints, management of complaint and grievance process, patient and family advocacy, tracking and trending, reporting and… more
- EGA Associates (PA)
- …for Onboarding** AMA, DEA, NPI **Job Description** Physician Reviewer - Medicaid Grievance Hearings (1099 Contract Role) Location: Remote (US based) Schedule: As ... seeking board-certified physicians to serve as Vendor Physician Reviewers for Medicaid grievance cases. In this role, you will review clinical documentation and… more
- CareFirst (Baltimore, MD)
- …Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and determination of next steps for Government Program lines of ... and analyze all pertinent information in preparation of an appeal and/or grievance request. Access the appropriate database to implement accurate and timely entry… more
- Point32Health (Canton, MA)
- …. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per ... and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works collaboratively with… more
- Transdev (Dorchester, MA)
- …+ Research, compile, and prepare data for use in grievance hearings, arbitration proceedings, labor/management initiatives, collective bargaining negotiations, and ... Resources policies and governmental laws and regulations. + Manage the grievance process and provide comprehensive responses to complaints, grievances, and… more
- Fallon Health (Worcester, MA)
- **Overview** **This Intake Administrator position is in the Appeal and Grievance Department and may require training in our Worcester office 5 days/week from 8 am to ... and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with CMS regulations,… more
- LA Care Health Plan (Los Angeles, CA)
- …manner. Coordinates, tracks, and resolves internal and external appeal and grievance complaints for LA Care Plan Partners, including identifying opportunities for ... and other general operations units. + Ensures timely appeal and grievance reporting to regulatory agencies, internal Regulatory Affairs and Compliance Department,… more
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