• Remote RN Case Manager

    Actalent (Los Angeles, CA)
    …The Medi-Cal Appeals and Grievances senior RN will report to the Appeals and Grievances Manager . + In this role, you will perform accurate and ... CALIFORNIA BASED REMOTE RN CASE MANAGER HIRING NOW!! A large nation wide healthcare...shift) - 830am to 5pm. + The Medi-Cal Member Appeals and Grievances team is responsible for… more
    Actalent (01/25/25)
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  • Senior Manager , Medicare Product…

    Point32Health (Canton, MA)
    …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have ... and related filings, new benefit implementation, and product/vendor management processes. The Senior Manager will support annual assessment of new product… more
    Point32Health (01/03/25)
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  • Senior Regional Business Manager

    J&J Family of Companies (Indianapolis, IN)
    Johnson & Johnson Innovative Medicine is recruiting for a Senior Regional Business Manager , Site of Care, to lead the Great Lakes region. This region consists of ... we all belong. The role of the Regional Business Manager is to expand the sales of the Immunology...eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ; practice management, as well… more
    J&J Family of Companies (01/18/25)
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  • Senior Regional Business Manager

    J&J Family of Companies (Austin, TX)
    Johnson & Johnson Innovative Medicine is recruiting for a Senior Regional Business Manager , Site of Care, to lead the South Central region. This region consists ... we all belong. The role of the Regional Business Manager is to expand the sales of the Immunology...eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ; practice management, as well… more
    J&J Family of Companies (01/18/25)
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  • Medicare Pharmacy Coordinator

    Medical Mutual of Ohio (OH)
    …new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists ... new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists… more
    Medical Mutual of Ohio (12/20/24)
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  • Senior Medical Director - Sharp Health Plan

    Sharp HealthCare (San Diego, CA)
    …as needed.Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight...needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'… more
    Sharp HealthCare (01/19/25)
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  • People Relations Partner Associate III

    Volunteers of America Los Angeles (Los Angeles, CA)
    …, and complaints, refers complex matters to HR Employee Relations Specialist or Senior Manager of Employee Relations as required + Participates in training ... generalist work with 30%dedicated time committed to handling employee complaints, grievances , interactive processes, and disciplinary actions. + Experience with case… more
    Volunteers of America Los Angeles (12/11/24)
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  • Director of Employee Relations - Office…

    Gwinnett County Public Schools (Suwanee, GA)
    …of Employee Relations will assist in providing resolution in matters related to grievances and appeals , training and development to administrators and employees ... Support Personnel License issued by the Georgia Professional Standards Commission. Senior Professional Human Resources, SPHR or Professional Human Resources (PHR)… more
    Gwinnett County Public Schools (12/09/24)
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  • Associate General Counsel

    State of Massachusetts (Boston, MA)
    …and internal policy and procedure development and implementation. * Advise senior Treasury staff, Human Resources department, and employees on issues related ... and labor laws, including conducting workplace investigations and responding to grievances and employment claims. * Represent the Treasury in administrative… more
    State of Massachusetts (01/23/25)
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  • Director, Behavioral Health, Health Plans

    VNS Health (Manhattan, NY)
    …the administration of all BH QM/UM and performance improvement activities, encompassing grievances and appeals , and contributes to various other subcommittees ... leadership and medical director meetings as stipulated by the State BH contract manager . Serves as the principal behavioral health/social care expert and liaison for… more
    VNS Health (12/04/24)
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