- Highmark Health (Hartford, CT)
- …of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals ; initiates a case file for each grievance and appeal; ensures ... all involved parties. + Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross… more
- CVS Health (Hartford, CT)
- …Management Analyst will be responsible for the end-to-end practitioner appeals process and business immediate termination letters. This will include coordination ... Qualifications** -Act as subject matter expert for individual practitioner appeals and immediate termination letters. -Create and collect all documentation… more
- The Cigna Group (Bloomfield, CT)
- Nurse Case Management Lead Analyst -Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for reviewing escalated clinical ... experience is preferred in prior authorization or utilization review and appeals + Demonstrated proficiency with Microsoft Office software; basic database navigation… more