- Point32Health (FL)
- …Point32Health (https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- Point32Health (MA)
- …(https://www.point32health.org/) . **Job Summary** SUMMARY Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- AmeriHealth Caritas (Philadelphia, PA)
- …. **This position is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible for the ... full life cycle of assigned member and/or provider appeals and grievance cases. Working under general...and regulatory guidance. + Communicate with members, providers, or representative to clarify appeal intent and gather missing documentation… more
- Humana (Lansing, MI)
- …of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties… more
- Fallon Health (Worcester, MA)
- …us on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance ... standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH… more
- Fallon Health (Worcester, MA)
- …and appeals , which includes,sending the appropriate acknowledgement of the grievance /appeal, educating the member and/or member representative about the ... us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance… more
- MTA (New York, NY)
- Senior Labor Relations Representative Job ID: 12716 Business Unit: MTA Headquarters Location: New York, NY, United States Regular/Temporary: Regular Department: ... Date Posted: Aug 15, 2025 Description JOB TITLE: Senior Labor Relations Representative DEPT/DIV: Labor Relations WORK LOCATION: 420 Lexington Ave FULL/PART-TIME FUL… more
- BrightSpring Health Services (Bowling Green, KY)
- …to Member and Provider issues. Refer all unresolved issues to the next level including grievance and appeals . + Actively market plan to new senior care partners ... Health Plan was formerly Signature Advantage* We are seeking a Sales Account Representative /Executive for our Abilis Health Plan who will work with senior care… 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
- City of New York (New York, NY)
- …contractual issues that may arise with CFB employees. - Serve as the CFB's grievance representative and administer the contractual grievance process. Serve ... as Hearing Officer for grievances and disciplinary appeals . Represent the agency at hearings before the Office of Labor Relations and arbitration sessions at the… more
- State of Colorado (Pueblo, CO)
- …and respond to youth grievances in accordance with DYS Policy 13.2 Grievance Procedures. Responsible for logging grievances on the tracking form and submitting ... resolves youth grievances. + Serves as the primary youth grievance officer to ensure rights, practices and policies are...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
- State of Colorado (Canon City, CO)
- …at the informal level; + Ensures staff compliance with the offender grievance process, offender co-pay, electronic data entry, and information systems requirements; ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (CO)
- …referrals and consultations, medical reporting, medical co-signature and inmate grievance requirements are completed in accordance with DOC Administrative ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- New York State Civil Service (Albany, NY)
- …Review and conduct agency level panel meetings associated with performance evaluation appeals as a representative of the employer;* Support the Bureau ... the various negotiated union agreements governing employment within SED, and conduct grievance hearings to resolve disputes concerning the terms and conditions of… more
- Sioux City Community School District (Sioux City, IA)
- …and develop communication for donor stewardship including thank you letters, appeals , newsletters, social media, impact reports, and other communications. + Plan ... perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, education and/or ability required. Reasonable… more