• Appeals and Grievances Quality…

    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 (03/08/25)
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  • Supervisor, Appeals & Grievances

    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
    Point32Health (03/14/25)
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  • Quality Management Appeals

    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
    UCLA Health (03/04/25)
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  • Manager , Grievance and Appeals , RN

    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
    VNS Health (03/05/25)
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  • Appeals & Grievances Coordinator

    Point32Health (Canton, MA)
    …and communities. **Job Summary** Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational ... more
    Point32Health (03/08/25)
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  • Supervisor, Appeals and Grievances

    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
    LA Care Health Plan (03/20/25)
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  • Supervisor, Appeals Grievance (State)

    Centene Corporation (Sacramento, CA)
    appeals , and grievance strongly preferred.** **Position Purpose:** The Supervisor of Appeals & Grievances is accountable for the recruitment, hiring, ... more
    Centene Corporation (03/14/25)
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  • Clinical Appeals Supervisor (Hybrid)

    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
    CareFirst (03/04/25)
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  • Nurse Appeals Associate

    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
    Elevance Health (03/20/25)
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  • Senior Manager , Medicare Advantage…

    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
    UCLA Health (03/04/25)
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  • Manager , Employee & Labor Relations

    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
    University of Delaware (03/19/25)
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  • Case Manager RN

    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
    HCA Healthcare (02/06/25)
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  • Delegation and Quality Oversight Manager

    CareOregon (Portland, OR)
    …subcontracted entities, fraud waste and abuse prevention planning and investigations, grievances , hearings and appeals , corporate risk assessment and compliance ... more
    CareOregon (03/18/25)
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  • Manager ROI Audit Research

    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
    Beth Israel Lahey Health (02/14/25)
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  • Universal Preschool Program(UPP) Operations…

    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 (03/15/25)
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  • Office of Public Safety Communications Microwave…

    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
    State of Colorado (03/04/25)
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  • Human Services Division Manager Range A/B

    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
    Sacramento County (03/05/25)
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  • Behavioral Health Compliance Manager

    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
    Ventura County (03/17/25)
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  • LTSS Service Coordinator (Case Manager

    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
    Elevance Health (03/07/25)
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  • Senior Provider Relations Manager

    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
    Magellan Health Services (02/08/25)
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