- Centene Corporation (Tempe, AZ)
- …**Position Purpose:** Analyze and resolve verbal and written claims and authorization grievance / appeals from providers and members. Resolve all State inquires ... million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization...* Act as subject matter expert regarding grievances and appeals . * Lead Appeals and Grievance… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Grievance and Appeals Coordinator 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #660 Wednesday, June 5, 2024 Centers Plan for Healthy Living's goal is ... living. JOB SUMMARY: As an integral part of the Grievance and Appeals (G&A) Department, the G&A Coordinator lends their support in processing member-related… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position SummaryCreated grievance and appeals cases in the G&A system and sends acknowledgement ... Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose… more
- LA Care Health Plan (Los Angeles, CA)
- …Appeals and Grievances Coordinator I supports the Customer Solution Center Appeals & Grievance Specialists by handling the administrative functions of the ... Customer Solution Center Appeals and Grievances Coordinator I Job...staff to render decisions, assists the Customer Solution Center Appeals & Grievance Manager and Director in… more
- Magellan Health Services (San Diego, CA)
- …case management and processes appeal requests. In some cases may be combined with Grievance Coordinator functions. + Maintains a caseload and monitors day to day ... ensuring documents meet standards and are accurate. General Job Information Title Appeals Coordinator Grade 19 Work Experience - Required Customer Service… more
- CVS Health (Harrisburg, PA)
- … care more personal, convenient and affordable. Position Summary The Medicare Grievance Sr. Coordinator will fully research and resolve beneficiary complaints. ... Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose… more
- CVS Health (Fresno, CA)
- …carrying a modified case load including but not limited to:-Research incoming electronic appeals , complaints and grievance to identify if appropriate for unit ... Bring your heart to CVS Health . Every one of us at CVS ...and reroute inappropriate work items that do not meet appeals , complaints and grievance criteria. -Research Standard… more
- Washington County Mental Health Services (Barre, VT)
- …on compliance with AHS and DAIL regulations as pertains to Master Grant requirements, grievance and appeals , and the DAIL/DDS System of Care Plan; Monitor and ... Position Title: Administrative Coordinator Division: Community Developmental Services (CDS) Supervised by: CDS Director Summary of Administrative Coordinator :… more
- University of Utah Health (Murray, UT)
- …assigned departments and/or programs. + As needed, perform reviews on utilization review, appeals and grievance cases. + Support Sales and Marketing departments ... **Overview** **The University of Utah Health Plan Chief Medical Officer (CMO), is a...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more
- State of Colorado (Denver, CO)
- …Model, all committed youth at each youth center are assigned a Behavioral Health Specialist who provides individual therapy each week. They also attend at least ... This position serves a complex adolescent population with various behavioral health disorders, trauma, and criminal behaviors. This position functions as a… more
- HCA Healthcare (Asheville, NC)
- …for over sight of the Contract Liaison, HIMS Clerk and Service Delivery, Appeals and Grievance (SDAG) Coordinator . Essential Accountabilities: + Develops ... CarePartners, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and… more