• Quality Management Appeals and Grievances

    UCLA Health (Los Angeles, CA)
    …point of contact for receipt of member-initiated complaints and Health Plan grievances and appeals. The Grievance and Appeals Intake Coordinator is responsible for ... more
    UCLA Health (03/04/25)
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  • Appeals & Grievances Coordinator

    Point32Health (MA)
    …**Job Summary** Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational aspects of the Member ... more
    Point32Health (03/22/25)
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  • Coord Appeals & Grievances

    AmeriHealth Caritas (Philadelphia, PA)
    …at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances , this position is responsible for the administrative tasks ... more
    AmeriHealth Caritas (03/11/25)
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  • Lead Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    Lead Customer Solution Center Appeals and Grievances Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los ... more
    LA Care Health Plan (03/19/25)
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  • Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... more
    LA Care Health Plan (03/04/25)
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  • Supervisor, Appeals and Grievances Clinical…

    LA Care Health Plan (Los Angeles, CA)
    Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... more
    LA Care Health Plan (03/20/25)
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  • Supervisor, Appeals & Grievances

    Point32Health (MA)
    …SUMMARY Under the general direction of the Senior Manager of Appeals and Grievances the Appeals and Grievance Supervisor, through the use of general knowledge of ... more
    Point32Health (03/14/25)
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  • Appeals and Grievances Quality Auditor

    Point32Health (MA)
    …communities. **Job Summary** Under the direction of the A&G Manager, the Appeals & Grievances QA Auditor audits the quality of letters and keyed entries from the ... more
    Point32Health (03/08/25)
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  • Appeals & Grievances Regulatory Audit…

    LA Care Health Plan (Los Angeles, CA)
    Appeals & Grievances Regulatory Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... more
    LA Care Health Plan (02/02/25)
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  • Appeals & Grievances Program Advisor

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA-Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the Appeals ... more
    Commonwealth Care Alliance (01/24/25)
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  • Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... more
    LA Care Health Plan (03/19/25)
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  • QA Auditor: Appeals and Grievances - RN…

    Healthfirst (NY)
    …and Responsibilities:** + Conduct quality audits of A&G items including grievances , pre-service appeals, and post service appeals utilizing appropriate sources of ... more
    Healthfirst (03/11/25)
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  • Appeals and Grievances Clinical Specialist…

    Healthfirst (AL)
    …+ Experience in clinical practice with experience in appeals & grievances , claims processing, utilization review or utilization management/case management. + ... more
    Healthfirst (02/22/25)
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  • Manager, Grievance and Appeals, RN

    VNS Health (Manhattan, NY)
    …to: * Lead with Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long Term Care (MLTC), Medicare Advantage ... more
    VNS Health (03/05/25)
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  • Service Excellence Officer

    Highmark Health (Monroeville, PA)
    …RESPONSIBILITIES** + Effectively triage, investigate, resolve and document complaints and grievances while ensuring adherence to the Patient Bill of Rights, ... more
    Highmark Health (02/07/25)
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  • Sr. Labor and Employee Relations Officer

    Washington Metropolitan Area Transit Authority (New Carrollton, MD)
    …including investigations and the administration of disciplinary actions and contract grievances , using extensive knowledge of WMATA's five (5) collective bargaining ... more
    Washington Metropolitan Area Transit Authority (03/19/25)
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  • Sr Appeal and Grievance Coordinator - Prefer…

    CVS Health (Springfield, IL)
    …appeals. Responsible for managing to resolution of appeals, complaints and grievances scenarios for all products, which contain multiple issues and may ... more
    CVS Health (03/05/25)
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  • Grievance & Appeals Specialist, Clinical

    VNS Health (Manhattan, NY)
    OverviewResolves grievances , appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage ... more
    VNS Health (02/07/25)
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  • Human Resource Analyst 3

    Commonwealth of Pennsylvania (PA)
    …responsible for conducting disciplinary investigations, investigating and resolving union grievances , acting as the employer advocate at unemployment compensation ... more
    Commonwealth of Pennsylvania (03/22/25)
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  • Hearing Officer

    TAD PGS, Inc. (Chicago, IL)
    …+ Acts as the hearing officer in connection with union grievances , schedules grievance hearings, coordinates hearings with necessary parties, interprets collective ... more
    TAD PGS, Inc. (03/14/25)
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