- VNS Health (Manhattan, NY)
- …criteria. + Enters data and assists with compiling reports and analysis on the grievance and appeals process. + Participates in special projects and performs ... more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... more
- LA Care Health Plan (Los Angeles, CA)
- …meet and/or exceed member satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring work, providing ... more
- BayCare Health System (Clearwater, FL)
- …must reside in Florida Equal Opportunity Employer Veterans/Disabled **Position** Intake Specialist Appeal and Grievance - Health Plan **Location** ... more
- 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, ... more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and ... more
- 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, ... more
- Commonwealth Care Alliance (Boston, MA)
- …& Responsibilities:** + Conduct monthly case review of a random sample of appeals and grievance cases against previously developed scorecard and Federal and ... more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- Title: Labor/Employee Relations Specialist I/ II/ III (Non-competitive Progression) Location: United States-Virginia-Virginia Beach Job Number: 250000Q1 Note: This ... more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Nurse Specialist serves as the key resource for the investigation of member complaints, grievances, quality of care and ... more
- MyFlorida (Tampa, FL)
- …of incident reporting, fatality reviews and continuous quality improvement reports, grievance / appeals and use this information initiate regional improvements. ... more
- State of Massachusetts (Shirley, MA)
- …ensuring accuracy of information to be transferred to the database; Enter grievance and disciplinary appeals as directed; conduct CJIS background checks ... more
- Transportation Security Administration (San Diego, CA)
- …segment are consistent with Merit System Principles. Review decision letters regarding appeals and grievance for accuracy prior to delivery. Formulate creative ... more
- Transportation Security Administration (San Diego, CA)
- …technical aspects of the work directed (employee relations principles and practices, appeals and grievance processes, OWCP, position management, staffing, human ... more
- State of Colorado (Chaffee County, CO)
- …responding to offender disciplinary appeals , answering offender classification appeals , review of offender grievance responses, and gathering information ... more
- Johns Hopkins University (Baltimore, MD)
- …actions and make sound recommendations to management. + Manage the grievance process, including fact finding, reviewing evidence, serving as hearing officer, ... more
- State of Colorado (CO)
- …referrals and consultations, medical reporting, medical co-signature and inmate grievance requirements are completed in accordance with DOC Administrative ... more
- LA Care Health Plan (Los Angeles, CA)
- …Summary The Supervisor, Authorization Technician supports the Utilization Management (UM) Specialist by handling all administrative and technical functions of the ... more
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