- VNS Health (Manhattan, NY)
- …criteria. + Enters data and assists with compiling reports and analysis on the grievance and appeals process. + Participates in special projects and performs ... more
- VNS Health (Manhattan, NY)
- …to established procedures. Maintains confidentiality of information. + Maintains knowledge of Grievance and Appeals (G&A) procedures, and CMS and DOH regulatory ... 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
- Centene Corporation (Tallahassee, FL)
- …strongly preferred.** **Position Purpose:** Supervise the day to day operations of the Appeals and Grievance (A&G) staff and functions within the department ... more
- Centene Corporation (Sacramento, CA)
- …**Remote-CA. Must reside in California **Healthcare lead experience with claims, appeals , and grievance strongly preferred.** **Position Purpose:** The ... more
- Point32Health (TX)
- …partners, colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and ... 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 ... more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written ... more
- AmeriHealth Caritas (Philadelphia, PA)
- …of medical management authorizations.; + Research and Investigate member and/or provider appeals and grievance requests, including review of UM/claim denial ... more
- CVS Health (Providence, RI)
- …ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly ... more
- CVS Health (Hartford, CT)
- …ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly ... more
- UCLA Health (Los Angeles, CA)
- Description The Appeals & Grievance Intake Coordinator serves as the primary point of contact for receipt of member-initiated complaints and Health Plan ... more
- Point32Health (MA)
- …& Grievances QA Auditor audits the quality of letters and keyed entries from the Grievance and Appeals systems. Checks cases built by other associates to ensure ... more
- LA Care Health Plan (Los Angeles, CA)
- …Grievances is responsible for assisting with the development of a successful and cohesive Appeals and Grievance unit, with a high level of productivity to ... more
- Commonwealth Care Alliance (Boston, MA)
- …& Responsibilities:** + Conduct monthly case review of a random sample of appeals and grievance cases against previously developed scorecard and Federal and ... more
- Point32Health (MA)
- …the general direction of the Senior Manager of Appeals and Grievances the Appeals and Grievance Supervisor, through the use of general knowledge of Plan ... more
- City and County of San Francisco (San Francisco, CA)
- …hearings; health and retirement benefits forms, state disability forms, grievance appeals , certification, language proficiency approvals, and affirmative ... more
- Corewell Health (Grand Rapids, MI)
- …experience Extensive knowledge of CMS regulations and process + Previous experience with grievance and appeals processes About Corewell Health As a team member ... more
- Humana (Columbus, OH)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... more
- Highmark Health (Dover, DE)
- …This position is also responsible for assisting members in navigating the grievance and appeals process and representing member interests internally and ... more
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