- Harbor Health Services, Inc. (Mattapan, MA)
- …and consistency of decisions. Supervisory responsibilities for UM RN, Quality Analyst , Appeals and Grievances Specialist. Requirements: Bachelor's Degree ... of quality measures and other data by the Quality Analyst for report to regulatory agencies, including CMS and...all aspects of managed care medical management including UM/CM, Grievance and Appeals , inpatient and outpatient services,… more
- Point32Health (Canton, MA)
- …direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- CVS Health (Boston, MA)
- …obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals , SIU, etc. + Coordinates provider status information ... data within Aetna QNXT. + Team will also include provider operations analyst and potential pre-cred support for implementation activities. + Provides assistance and… more
