- Elevance Health (Walnut Creek, CA)
- ** Manager I - Grievances & Appeals - Member Appeals ** **Location** : This position will work a hybrid model (in office 1-2 days per week). The ideal ... within 50 miles of one of our Elevance Health PulsePoint locations in California. The ** Manager I - Grievances & Appeals ** is responsible for management… more
- Elevance Health (Walnut Creek, CA)
- …**How you will make an impact:** + Conducts investigations and reviews of member and provider medical necessity appeals . + Reviews prospective, inpatient, or ... forwards to Medical Director for approval. + Ensures that appeals and grievances are resolved timely to...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Walnut Creek, CA)
- …entities. + Utilizes leadership skills and serves as a subject matter expert for appeals / grievances /quality of care issues and is a resource for clinical and non ... **Nurse Appeals (Quality) - California candidates only** **Location: This...impact:** Responsible for investigating and processing quality of care grievances from members and providers. **Primary duties may include,… more
- Randstad US (Pleasanton, CA)
- …peers in self-managed teams to meet deadlines. Preferred Qualifications: Knowledge of member grievance and appeals process preferred., Knowledge of federal and ... case manager . + pleasanton , california + posted august...and grievance handling, compliance, documentation and enhancement of the member experience. + Partner with and outreach to internal… more