- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor (RN) directs and coordinates the accurate implementation of the clinical appeal ... and serves as a resource for associates within the Clinical Appeals and Analysis unit supporting Government...data related to the volume and complexity of the appeals and grievances submitted for resolution. **SUPERVISORY… more
- State of Colorado (Arapahoe County, CO)
- CORRECTIONAL, YOUTH, OR CLINICAL SECURITY SUPERVISOR III - Marvin W. Foote YSC - Englewood, CO Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4797351) Apply CORRECTIONAL, YOUTH, OR CLINICAL SECURITY SUPERVISOR III - Marvin W. Foote YSC -… more
- Veterans Affairs, Veterans Health Administration (IN)
- …direct work, assigns tasks, evaluate work, advises employees, handle complaints, and grievances with the oversight of the supervisor Evaluate unit productivity, ... VA Handbooks and Directives Respond to inquiries about disciplinary actions, grievances , and appeals concerning timeliness, documentation, and other requirements… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- …meets the standards for acceptable medical care. + Reviews and resolves retro reviews, appeals and grievances related to medical quality of care and actively ... participates in the functioning of the plan's grievance and appeals processes. + Along with the nurse supervisor and manager identify opportunities for… more
- State of Colorado (Colorado Springs, 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
- Veterans Affairs, Veterans Health Administration (Dallas, TX)
- …complaints of ICT's and refers others, such as possible disciplinary actions, formal grievances and appeals , to the supervisor . Communicates team consensus ... on work in progress, and reviews completed work to see that the supervisor 's instructions on work priorities, methods, deadlines, and quality have been met. Serves… 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
- Dignity Health (Bakersfield, CA)
- …manner to the health plan. - Partners as needed with the appeals and grievances functions of the department. **Qualifications** **Minimum Qualifications:** ... Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a… more
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