- LA Care Health Plan (Los Angeles, CA)
- …(LAC) membership. This position will ensure the effective investigation and resolution of clinical grievances , appeals , complaints, and complex issues in ... achieve regulatory standards. Acts as a back-up to the Supervisor in leading meetings and handling escalations as required....Registered Nurses Experience Required: At least 8 years of clinical appeals and grievances experience… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Job Summary** As the Supervisor , Appeals and Grievances ...of 3 years of experience leading a team of clinical and non clinical staff + Minimum ... Services, Legal, and Compliance to ensure Consistent resolution of appeals and grievances **Education and Experience** +...to ensure Consistent resolution of appeals and grievances **Education and Experience** + Associate Degree in Health… more
- Fallon Health (Worcester, MA)
- …other applicable regulatory requirements and member and provider expectations. The FH Appeals and Grievances Triage Administrator serves to administer the FH ... standards. The Triage Administrator is responsible for triaging and assigning all incoming appeals and grievances addressed to the Member Appeals &… more
- Modivcare (AR)
- …may be the right fit for you! Modivcare is looking for an experienced Supervisor - Success & Investigative Services to join our team. This role is responsible ... to ensure a high level of customer service and reduce complaints and grievances . This role focuses on identifying trends, supporting staff through coaching and… more
- State of Colorado (Pueblo, CO)
- …and reporting. Other duties include: Organizational Management and Supervision: + Unit supervisor for 10 staff members, including direct supervision of 3 individual ... disciplinary actions; approves leaves; assigns work schedules; resolves informal grievances ; establishes acceptable work standards; sets priorities; initiates hiring… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- …issues resolving simple, informal complaints of employees and referring others, such as formal grievances and appeals , to the supervisor or an appropriate ... Summary The Lead Health Technician (Telehealth Clinical ) serves within the Education & Learning Resources...direction relating to the telehealth program working with the supervisor to develop assignments for team members in order… more
- State of Colorado (Pueblo, CO)
- …and restrictions pertinent to patient treatment and safety. Alerts the supervisor with recommendations for additional training/teaching when an increase in any ... + Addresses patient complaints/complaints of family and resolves patient grievances at the unit level. + Aware of patient...and utilizes this person as a resource when necessary. Clinical Skills: + This position ensures that the client's… more
- WellSpan Health (Lewisburg, PA)
- …+ Resolves simple or informal complaints and refers formal grievances or appeals to appropriate officials. + Intercedes with supervisor on behalf of team ... all Technician level tasks. + Provides feedback to Logistics & Distribution Supervisor on co-worker's performance. Provides input to supervisor for performance… more
- State of Colorado (Denver, CO)
- …+ 1 - 2 years + Less than a year 03 How many years of experience do you have as clinical supervisor ? + 2 or more years + 1 - 2 years + Less than a year 04 How ... of health care including physical, psychiatric, and dental maintenance. Clinical Management: Functions as the facility responsible health authority (RHA).… more
- State of Colorado (Centennial, CO)
- …+ 1 - 2 years + Less than a year 03 How many years of experience do you have as clinical supervisor ? + 2 or more years + 1 - 2 years + Less than a year 04 How ... of health care including physical, psychiatric, and dental maintenance. Clinical Management: Functions as the facility responsible health authority (RHA).… more
- University of Colorado (Aurora, CO)
- …and university leadership. + Address faculty concerns regarding grievance procedures, and appeals processes and serve as a neutral party and advisor in faculty ... grievances , promotion disputes, performance reviews, and departmental conflicts. +...faculty workforce planning, and compliance reporting. + **Academic & Clinical Excellence** - Personal record of achievement in education,… more
- Beth Israel Lahey Health (Westwood, MA)
- …information. Escalates calls to pharmacists for clinical inquiries and escalates grievances to supervisor . 7. Maintains new and existing patient profiles and ... Support health care providers with required prior authorization and required appeals . Manage all mail/delivery of Rx orders including addressing problems/issues with… more
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