- Elevance Health (Richmond, VA)
- **Title: Grievance / Appeals Analyst II** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of one of our PulsePoint locations. The ** Grievance / Appeals Analyst II** will be responsible for reviewing, analyzing and processing non-complex and some… more
- Elevance Health (Topeka, KS)
- ** Grievance / Appeals Analyst I** **Candidates must be located within 50 miles of Topeka, KS** The ** Grievance / Appeals Analyst I** is an entry ... level position in the Enterprise Grievance & Appeals Department that reviews, analyzes...accreditation and regulatory standards and requirements. As such, the analyst will strictly follow department guidelines and tools to… more
- Elevance Health (Richmond, VA)
- **Title: Grievance / Appeals Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of one of our PulsePoint locations. The ** Grievance / Appeals Analyst I** is an entry level position in the Enterprise Grievance & Appeals Department… more
- Henry Ford Health System (Troy, MI)
- …for the prompt and thorough investigation of medical and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare Advantage, ... Medicare-Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide root/cause analysis when… more
- CVS Health (Columbus, OH)
- …staff education **Required Qualifications** Compliance experience Audit Experience Grievance and Appeals Experience **Preferred Qualifications** **Education** ... High School Diploma or GED **Pay Range** The typical pay range for this role is: $19.52 - $36.78 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base… more
- Henry Ford Health System (Troy, MI)
- …necessary internal control oversight information regarding system changes affecting the Appeals & Grievance processing ensuring that proper system testing, ... Appeals and Grievances. + Prepares all appeal and grievance data for regulatory agency reviews (NCQA, CMS, DIFS... data to identify impacting trends, perform root cause analyst and recommend customer service and process improvements. Coordinate… more
- City of Cincinnati (Cincinnati, OH)
- …have knowledge and experience with collective bargaining agreements, corrective action, and grievance and appeals procedures; must be skilled in analyzing and ... HUMAN RESOURCES ANALYST (GENERALIST) Print (https://www.governmentjobs.com/careers/cincinnati/jobs/newprint/4674095) Apply HUMAN RESOURCES ANALYST (GENERALIST)… more
- The Cigna Group (Bloomfield, CT)
- …with every other weekend (Tuesday ALT Day).** + Must have experience in Medicare Appeals , Utilization Case Management or Compliance in Medicare Part C + Ability to ... differentiate different types of requests Appeals , Grievances, coverage determination and Organization Determinations in order to ensure the correct processing of… more
- Sacramento County (Sacramento, CA)
- …years of experience in Sacramento County service in the class of Senior Personnel Analyst or Labor Relations Representative. Or: 2. Four years of experience in a ... duties, including a minimum of one year experience in discipline, grievance investigation, arbitration, or labor negotiations (public sector experience is highly… more
- City and County of San Francisco (San Francisco, CA)
- …members of the public or as elevated through the Citywide ADA Grievance procedure or other responsive complaints mechanisms. Develop recommendations for barrier ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...the online application was not submitted or received. Exam Analyst Information: If you have any questions regarding the… more
- State of Colorado (Denver, CO)
- …administrative needs and provide administrative updates. + Conduct investigative or grievance respondent support when requested by the executive team. + Review, ... experience as an executive level administrator, a professional administration analyst or specialist providing consultation and expertise to executive teams,… more
- City and County of San Francisco (San Francisco, CA)
- …the City in state and federal civil litigation (through trial and appeals ), in administrative proceedings involving employment and labor matters, and provides ... 30 unions that represent City employees, including collective bargaining, labor grievance arbitrations, and defending unfair labor practice and other administrative… more
- LA Care Health Plan (Los Angeles, CA)
- …following 3 health plan functions: Call Center Operations, Enrollment Services Operations, Appeals & Grievance Operations For Advanced Analytics Lab: Preferred: ... experience requirement. Preferred: Experience in leading a team of data analyst knowledgeable in SQL. Experience and knowledge in Python and/or R… more