• Supervisor, Appeals & Grievances

    Point32Health (MA)
    …**Job Summary** SUMMARY Under the general direction of the Senior Manager of Appeals and Grievances the Appeals and Grievance Supervisor, through ... more
    Point32Health (03/14/25)
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  • Appeals & Grievances Regulatory…

    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, ... more
    LA Care Health Plan (02/02/25)
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  • Appeals and Grievance Analyst

    Point32Health (Canton, MA)
    …general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... more
    Point32Health (03/20/25)
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  • Sr Appeals & Grievance Analyst

    Point32Health (MA)
    …**Job Summary** Under general direction of the Supervisor of Member Appeals and Grievances , the primary function of the Sr. Analyst is to ensure the ... more
    Point32Health (03/20/25)
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  • Human Resource Analyst 3

    Commonwealth of Pennsylvania (PA)
    Human Resource Analyst 3 Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4868263) Apply  Human Resource Analyst 3 Salary $66,250.00 - ... more
    Commonwealth of Pennsylvania (03/24/25)
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  • Senior Human Resources Analyst - Multiple…

    City and County of San Francisco (San Francisco, CA)
    …bargaining agreements. + Key duties include negotiating resolutions to grievances , investigating complaints of serious employee misconduct, and conferring with ... more
    City and County of San Francisco (01/15/25)
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  • Business Analyst III

    LA Care Health Plan (Los Angeles, CA)
    …Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and Grievances : This position requires work after ... more
    LA Care Health Plan (02/23/25)
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  • Provider Payment Appeal Analyst II

    Elevance Health (Norfolk, VA)
    …to manage Claim Payment Appeal escalations and may serve as a liaison between grievances & appeals and /or medical management, legal, service operations and/or ... more
    Elevance Health (03/20/25)
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  • Medicaid Senior Business Process Analyst

    Highmark Health (Camp Hill, PA)
    …materials for responding to external audit requests. + Provide support in the appeals & grievances and complaints tracking & resolution processes impacting ... more
    Highmark Health (02/25/25)
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  • Senior Analyst , Network Relations

    CVS Health (Springfield, IL)
    …building. + Coordinate with Network Management to issue provider CAP + Monitor Grievances according NCQA standards categories (3 grievances per QTR), including ... more
    CVS Health (03/15/25)
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  • Analyst , Client Analytics

    Evolent (Columbus, OH)
    …supporting Evolent's clinical services (ie, specialty care, utilization management, care management, appeals & grievances ) + Using analytical tools to integrate ... more
    Evolent (03/22/25)
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  • Senior Analyst , Employee Relations

    Tiffany & Co. (New York, NY)
    …retaliation, wage and hour violations, disciplinary actions, and employee and applicant appeals and grievances when requested + Ensure consistent and equitable ... more
    Tiffany & Co. (03/05/25)
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  • Senior Dental Analyst , Pharmacy Department

    Healthfirst (NY)
    …an at-a-glance view of key performance indicators (KPIs), member feedback based on appeals and grievances , utilization and spend across our Healthfirst products. ... more
    Healthfirst (02/19/25)
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  • Health Facilities Evaluator III

    The County of Los Angeles (Los Angeles, CA)
    …personnel in their unit and effectively recommending the adjustment of grievances and disciplinary problems. Other positions are assigned such functions as: ... more
    The County of Los Angeles (03/06/25)
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