• Grievance & Appeals Specialist

    VNS Health (Manhattan, NY)
    OverviewResolves grievances , appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare ... each grievance or appeal decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers. Assists with… more
    VNS Health (02/07/25)
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  • Health Benefits Information Specialist

    City of New York (New York, NY)
    …with beneficiaries to answer questions and clarify Medicare Advantage plan specifics. Appeals and Grievances Support: - Assist beneficiaries in understanding ... to join our team as a Health Benefits Information Specialist . In this role, you will be tasked to...educate and empower our community. The Health Benefits Information Specialist plays a key role in assisting Medicare beneficiaries… more
    City of New York (02/12/25)
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  • Standards Specialist

    City of New York (New York, NY)
    …of Correction ("DOC" or "the Department"); - Investigate serious incidents; - Review grievances from people in custody and staff; - Evaluate the performance of DOC; ... a period of growth and change. JOB DESCRIPTION The Board seeks a Standards Specialist ("Monitor") with a passion for justice, fairness, and human rights, and the… more
    City of New York (03/07/25)
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  • National Contracting Director (Value Based)

    Molina Healthcare (Yonkers, NY)
    …for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances . * Coordinates with Corporate and Business ... Provides training and guidance as needed to the Contract Managers and Contract Specialist (s). * Helps develop and utilize standardized contract templates and Pay for… more
    Molina Healthcare (03/04/25)
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