• Grievance & Appeals Specialist,…

    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 (02/07/25)
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  • Senior Coordinator, Grievance

    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 (03/07/25)
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  • Manager, Grievance and Appeals , RN

    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
    VNS Health (03/05/25)
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  • Supervisor, Grievance & Appeals

    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 (03/12/25)
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  • Supervisor, Appeals Grievance

    Centene Corporation (Sacramento, CA)
    …**Remote-CA. Must reside in California **Healthcare lead experience with claims, appeals , and grievance strongly preferred.** **Position Purpose:** The ... more
    Centene Corporation (03/14/25)
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  • Appeals and Grievance Analyst

    Point32Health (TX)
    …partners, colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and ... more
    Point32Health (03/08/25)
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  • Appeals and Grievance Specialist…

    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 (01/28/25)
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  • Appeals and Grievance Coord

    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
    Baylor Scott & White Health (02/05/25)
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  • Coord Appeals & Grievances

    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
    AmeriHealth Caritas (03/11/25)
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  • Medical Director - Regulated Medicare…

    CVS Health (Providence, RI)
    …ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly ... more
    CVS Health (03/13/25)
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  • Medical Director - Medicare Appeals

    CVS Health (Hartford, CT)
    …ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly ... more
    CVS Health (03/04/25)
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  • Quality Management Appeals and Grievances…

    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
    UCLA Health (03/04/25)
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  • Appeals and Grievances Quality Auditor

    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
    Point32Health (03/08/25)
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  • Lead Customer Solution Center Appeals

    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
    LA Care Health Plan (03/19/25)
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  • Appeals & Grievances Program Advisor

    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
    Commonwealth Care Alliance (01/24/25)
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  • Supervisor, Appeals & Grievances

    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
    Point32Health (03/14/25)
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  • Personnel Technician

    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
    City and County of San Francisco (03/04/25)
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  • Appeal Analyst Pharmacy Medicare

    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
    Corewell Health (03/14/25)
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  • Medical Director - Care Plus - Florida

    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
    Humana (03/18/25)
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  • Outreach Representative

    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
    Highmark Health (03/13/25)
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