- Elevance Health (Costa Mesa, CA)
- ** Manager I - Grievances & Appeals - Provider Disputes** **Location** : This position will work a hybrid model (in office 1-2 days per week). The ideal ... Maine, Missouri, Virginia, Indiana, Kentucky or New York. The ** Manager I - Grievances & Appeals...management oversight of receipt, investigation and processing associated with member/ provider grievances and appeals . **How… more
- Elevance Health (Costa Mesa, CA)
- … appeals departmental units to investigate, resolve, and respond to client/ provider grievances / appeals and ensure compliance with regulatory requirements. ... will live within 50 miles of one of our PulsePoint locations. The ** Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and… more
- Elevance Health (Costa Mesa, CA)
- …will make an impact:** + Conducts investigations and reviews of member and provider medical necessity appeals . + Reviews prospective, inpatient, or retrospective ... forwards to Medical Director for approval. + Ensures that appeals and grievances are resolved timely to...or any combination of education and experience, which would provide an equivalent background. Current active unrestricted RN license… more