- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Appeals and Grievance (A&G) Coordinator is responsible, per State and ... Federal regulations, for assisting with all operational aspects of the Appeals and Grievances assignment process for Point32Health. Responsibilities include, but… more
- G-TECH Services, Inc. (Detroit, MI)
- Process appeals and grievances , analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. ... Skills/Experience - Optional but preferred skills/experience. Include: * Grievance and Appeals experience. * Degree in Healthcare/computer skills * Experience in… more
- Medical Mutual of Ohio (OH)
- …new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists ... new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists… more
- CVS Health (Frankfort, KY)
- …or provider/practitioner appeals . Responsible for managing to resolution of appeals , complaints and grievances scenarios for all products, which contain ... outside plan sponsors or regulators. -Research and resolve incoming electronic appeals , complaints and grievances as appropriate as a "single-point-of-contact"… more
- CVS Health (Charleston, WV)
- …and affordable. **Position Summary** Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
- LA Care Health Plan (Los Angeles, CA)
- …provided to third party vendor, SOVOS. (15%) Validate documentation provided by (A&G) Appeals & Grievances Dept. for member reimbursement request to ensure all ... Medical Payment Accounting Coordinator II Job Category: Accounting/Finance Department: Medical Payment...achieve that purpose. Job Summary The Medical Payment Processing Coordinator II is responsible for ensuring all System Application… more
- Air National Guard Units (Garden City, GA)
- …simple, informal complaints from SAPR VAs and refer other complaints, such as formal grievances and appeals , to the Supervisory Principal SARC or an appropriate ... This National Guard position is for a SEXUAL ASSAULT PREVENTION AND RESPONSE COORDINATOR , Position Description Number T5899000 and is part of the 165th Airlift Wing,… more
- Elevance Health (FL)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator ** _Location:_ This is a hybrid role. Candidate...Morristown) at least once a week. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
- Elevance Health (Miami Gardens, FL)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator ** _Location:_ This is primarily a field based...Miami-Dade, Broward, Hillsborough, Orange, or Polk. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
- Army National Guard Units (Edinburgh, IN)
- …simple, informal complaints from SAPR VAs and refer other complaints, such as formal grievances and appeals , to the Supervisory Principal SARC or an appropriate ... activities and oversee both military and civilian Sexual Assault Response Coordinator (SAPR) Victim Advocates (VAs). Apply basic strategies for skilled… more
- Highmark Health (Harrisburg, PA)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical ... staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification… more
- State of Colorado (Denver, CO)
- …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... retention; selection and selection appeals ; settlement advice; strategic planning and overall HR guidance to CDHS managers, supervisors and employees. The HR Shared… more
- Louisiana Department of State Civil Service (Jackson, LA)
- …of all personnel records; coordinating and processing of personnel forms/actions; appeals ; grievances , and disciplinary actions; performance appraisals; merit ... analysis, and recommendation of 6.5g's and OPA's; review of grievances that go to the Deputy Asst Secretary level;...Hearings. Provides information to the attorney and testifies in appeals as required or necessary. Serves as liaison with… more
- State of Colorado (Canon City, CO)
- …and online learning system. + Participate in the monthly Fleet Vehicle Coordinator update call to share any fleet safety and compliance-related updates, present ... regarding the program and procedural changes. + Attend monthly CDOC Vehicle Coordinator Update Meeting and provide guidance and leadership for all thing safety… more
- State of Colorado (Grand Junction, CO)
- …professional development training (as available). Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, ... interventions for all youth. Responds to and resolves youth grievances . Act as first public contact with agency when...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Greeley, CO)
- …This supervision entails assigning and evaluating work, handling informal grievances , initiating corrective and disciplinary actions, and participating in the ... This supervision entails assigning and evaluating work, handling informal grievances , initiating corrective and disciplinary actions, and participating in the… more
- State of Colorado (Golden, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Lakewood, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Golden, CO)
- …+ Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, follow up and appropriate action Shift Supervision + ... facility and throughout CYSOs + Functions as the training Coordinator for the facility. Train staff in DYS Policy...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- University of Kansas (Lawrence, KS)
- …the research, instruction and/or service of the School. + Manage petitions, grievances , and other special processes within SPS. These could include student ... petitions, charges of academic misconduct, grade appeals , retroactive withdrawals, and fee petitions. + Provide training to key stakeholders in SPS and across campus… more