- VNS Health (Manhattan, NY)
- …the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our grievance ... timely processing for the Medicare and Medicaid appeal and grievance processes, incidents, quality of care concerns and any...are educated and compliant with requirements of appeals and grievance regulations and processing. + Work closely with all… more
- Corewell Health (Grand Rapids, MI)
- …Summary Responsible for the analysis, research and completion of complex member grievance investigations. Effectively administer all steps of the member grievance ... compliance to all state, federal and accrediting organization requirements. The Grievance Analyst makes decisions on moderately complex issues and work is… more
- CVS Health (Charleston, WV)
- …units. Ensure timely, customer focused response to appeals, complaints and grievance . Identify trends and emerging issues and report and recommend solutions. ... -Research incoming electronic appeals, complaints and grievance to identify if appropriate for unit based upon...work items that do not meet appeals, complaints and grievance criteria. -Research Standard Plan Design or Certification of… more
- Point32Health (TX)
- …. **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
- VNS Health (Manhattan, NY)
- …maintains accurate records documenting the actions and rationale for each grievance or appeal decision. Develops correspondence communicating the outcome of ... and assists with compiling reports and analysis on the grievance and appeals process. For Fair Hearings: + Supports... and appeals process. For Fair Hearings: + Supports Grievance and Appeals on legal issues pertaining to State… more
- Elevance Health (Mason, OH)
- **Manager II Grievance /Appeals (RN)- Claims Support** **Location** : This position will work in a hybrid model (remote and office). Ideal candidates will live within ... locations. Expected Work Hours: Monday-Friday; 8AM-5PM EST The **Manager II Grievance /Appeals** is responsible for management oversight of grievances and appeals… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... complaints, appeals and grievance cases for products for all lines of business....+ Builds case files for each complaint, appeal and grievance , and ensures compliance with organizational and regulatory guidelines.… more
- ManpowerGroup (Rancho Cucamonga, CA)
- **Title: Temporary Coordinator - Grievance and Appeals** **Location:** **Rancho Cucamonga California 91730 (Hybrid)** **Schedule: Telecommute (once or twice a month ... Contract** **Pay Range $20.00 to $23.98/hr.** We are looking for a "Temporary Coordinator - Grievance and Appeals" to join one of our Fortune 500 clients. This is a… more
- G-TECH Services, Inc. (Detroit, MI)
- …Preferred Skills/Experience - Optional but preferred skills/experience. Include: * Grievance and Appeals experience. * Degree in Healthcare/computer skills * ... in analyzing a claim * Experience in classification between a grievance /appeal/organizational determination. * Letter writing * Basic computer skills. How to… more
- Transdev (New Carrollton, MD)
- …or watch an overview video athttps://youtu.be/ilO5cv0G4mQ QA Analyst Overview: Grievance /QA Analyst provide excellent customer service to both our passengers ... and our drivers. The starting rate is $20.00/hour. Responsibilities: + Conducts individual assessments via paper, telephone, and/or in person using standard questions, outline evaluation procedures + Working with managers and staff to improve performance +… more
- BayCare Health System (Clearwater, FL)
- …Equal Opportunity Employer Veterans/Disabled **Position** Intake Specialist Appeal and Grievance - Health Plan **Location** Clearwater:Park Place | Business and ... Administrative | Full Time **Req ID** null more
- Houston Methodist (Houston, TX)
- …management by providing quality monitoring and measurement of the grievance reporting process. Providing oversight and review during investigations associated ... Specialist position assists in training new Patient Liaisons on the Grievance Process, facilitating excellent communication. **PEOPLE ESSENTIAL FUNCTIONS** + Assists… more
- Bassett Healthcare (Cooperstown, NY)
- …processes to analyze and report patient safety, risk management and patient grievance data. The Director supports compliance with federal and state regulations and ... strategies and tactics for patient and staff safety and patient grievance programs. Institutes corrective actions and/or makes modifications to safety and… more
- Elevance Health (Columbus, OH)
- **Manager II Grievance /Appeals (RN)-California** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 ... locations. **Expected Work Hours:** Monday-Friday; 8am-5pm PST The **Manager II Grievance /Appeals** is responsible for management oversight of grievances and appeals… more
- TAD PGS, Inc. (Chicago, IL)
- …of management, serving as hearing officer or mediator for union grievance hearings, resolution meetings, and other labor/management activities. Aids Labor Counsel ... to arbitrations and other labor-related litigation. Research information from past grievance files, personnel records, salary grades of specific union job… more
- The Cigna Group (St. Louis, MO)
- …and analytics. The Senior Analysts' primary role will be to support the Grievance functions as it relates to the Medicare, Medicaid and Marketplace (Exchange / ... inventories. + Participates as SME in client meetings regarding grievance processes. + Coordinates or leads responses to ...grievance processes. + Coordinates or leads responses to Grievance RFPs + Collaborates with Grievance and… more
- Southern Glazer's Wine and Spirits (Lakeland, FL)
- …for maintaining and enhancing positive employee relations. Leads employee and grievance investigations and implementation of employee and labor relations strategies ... Manager, Employee and Labor Relations. **Primary Responsibilities** + Lead employee, grievance , and policy investigations for assigned client group. + Provide… more
- University of Massachusetts Amherst (Amherst, MA)
- …manages the implementation of the University's Academic Integrity and Grievance policies. Essential Functions + Provides campus-wide leadership operationalizing the ... for Formal Charge Appeal Hearings, University Sanction Hearings, and Academic Grievance Hearings. Attends hearings as a representative for the Academic Integrity… more
- Naval Air Systems Command (San Diego, CA)
- …advice on complex and controversial issues. You will offer assistance on grievance procedures along with ensuring official case files are properly maintained in ... with regulatory guidance. You will interpret policies and provide advice on grievance procedures and options for resolution of conflicts or problems. You will… more
- FirstEnergy (Akron, OH)
- …achieve cost effective and competitive labor agreements, contract administration, grievance and arbitration administration and preparation. This position also ... **Responsibilities:** + Negotiating collective bargaining agreements + Managing the grievance and arbitration process to ensure thorough, timely and effective… more
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