- CareFirst (Baltimore, MD)
- …membership, and support NCQA accreditation and the Divisional Goals for the Clinical Appeals and Grievance department. We are looking for an experienced people ... Worker Upon Hire Required + CCM - Certified Case Manager Upon Hire Preferred or + LNCC - Legal...Nurse Consultant, Utilization Management, and Government Program experience with Appeals and Grievance , Experience with MCG, InterQual,… more
- CareFirst (Baltimore, MD)
- …educational and training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in the development and ... 3 years supervisory experience Utilization Management, and Government Program experience with Appeals and Grievance , Experience with MCG, InterQual, NCD and… more
- CareFirst (Baltimore, MD)
- …organization or hospital preferred. + BSN/MSN Degree. Government Program experience with Appeals and Grievance , Experience with MCG, InterQual, NCD and LCD's. ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation...Licensure Upon Hire Required + CCM - Certified Case Manager Upon Hire Preferred + LNCC - Legal Nurse… more
- Maryland Department of Transportation (Anne Arundel County, MD)
- …as the delegated representative of the Secretary of Transportation for Second Step grievance appeals and disciplinary action appeals . + Negotiating the ... Labor Relations Manager (DOT Executive IV) Salary $95,991.00 - $154,928.00 Annually Location Anne Arundel County Job Type Full Time Remote Employment… more
- CareFirst (Baltimore, MD)
- …clinical platform, Guiding Care, supporting Care Management, Utilization Management, and Appeals and Grievance , ensuring system/product alignment with CareFirst ... defining and building reports and queries for key operational data. The Manager , Systems Operations is critical in ensuring systems optimization and availability in… more
- Johns Hopkins University (Baltimore, MD)
- …Hopkins Bayview Medical Center (JHBMC). This position reports to the DOM HR Manager with a reporting relationship to the Associate Administrator for the DOM, ... compensation administration and analysis; benefits administration; employee relations (including grievance resolution, disciplinary action, reductions in force, termination); training… more