- Point32Health (MA)
- …members, partners, colleagues and communities. **Job Summary** Under the direction of the A&G Manager , the Appeals & Grievances QA Auditor audits the quality ... more
- Point32Health (MA)
- …partners, colleagues and communities. **Job Summary** SUMMARY Under the general direction of the Senior Manager of Appeals and Grievances the Appeals and ... more
- UCLA Health (Los Angeles, CA)
- …from the Medical Director and QM Manager . + Review all member appeals and grievances for accuracy, ensuring that proper documentation from the requestor ... more
- VNS Health (Manhattan, NY)
- …Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and grievances . + Ensures the accuracy and integrity of data ... more
- Point32Health (Canton, MA)
- …and communities. **Job Summary** Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational ... more
- 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, ... more
- Centene Corporation (Sacramento, CA)
- …appeals , and grievance strongly preferred.** **Position Purpose:** The Supervisor of Appeals & Grievances is accountable for the recruitment, hiring, ... more
- CareFirst (Baltimore, MD)
- …educational and training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in the development and ... more
- Elevance Health (Columbus, OH)
- …and business leaders passionate about transforming American healthcare delivery. **Nurse Appeals Associate** **Location:** This position will work a virtual model. ... more
- UCLA Health (Los Angeles, CA)
- …be responsible for overseeing the strategic management and operational execution of Appeals and Grievances , Claims Processing, and Payment Integrity functions. ... more
- University of Delaware (Newark, DE)
- Manager , Employee & Labor Relations Job no: 501789 College / VP Area:Office of Human Resources Work type: Staff Location: Newark/Hybrid Categories: Human Resources, ... more
- HCA Healthcare (Rochester, NH)
- …set us apart from any other healthcare provider. We are seeking aCase Manager to join our healthcare family. **Benefits** Frisbie Memorial Hospital, offers a total ... more
- CareOregon (Portland, OR)
- …subcontracted entities, fraud waste and abuse prevention planning and investigations, grievances , hearings and appeals , corporate risk assessment and compliance ... more
- Beth Israel Lahey Health (Burlington, MA)
- … grievances involving colleagues; interview and select, with the manager , candidates for employment.** **Proactively develop plans to meet future ... more
- State of Colorado (Denver, CO)
- …Preschool Program(UPP) Operations Manager Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4868682) Apply Universal Preschool Program(UPP) ... more
- State of Colorado (Golden, CO)
- …of Public Safety Communications Microwave Engineer Manager Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4772302) Apply Office of Public ... more
- Sacramento County (Sacramento, CA)
- Human Services Division Manager Range A/B Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2234944) Apply Human Services Division Manager ... more
- Ventura County (Ventura, CA)
- …agencies as needed; + Serves as the compliance point of contact for grievances , appeals , and Notices of Adverse Benefit Determinations (NOABDs); + Supervises ... more
- Elevance Health (Scottsburg, IN)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + BA/BS degree ... more
- Magellan Health Services (Las Vegas, NV)
- …market - including managing the network portion around provider complaints and grievances . It will involve presenting results of our network compliance initiatives ... more
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