- BayCare Health System (Clearwater, FL)
- …member be working remotely? Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Grievance Specialist - Health Plan **Location** ... members to resolve disagreements, and ensuring adherence to regulatory requirements. + Triage, plan , and execute intake of Appeals and Grievance submissions. +… more
- VNS Health (Manhattan, NY)
- …analyzes and solves problems. Consults with the member, family, providers and health plan departments as necessary. Identifies and communicates key points ... Entities and Quality Improvement Organizations. + Collaborates with professionals, health plan departments such as Claims and...Fair Hearings. Attends Fair Hearings in person with the Grievance and Appeals' RN Specialist and presents… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... complaints, appeals and grievance cases for products for all lines of business....benefits package includes the following + Immediate eligibility for health and welfare benefits + 401(k) savings plan… more
- VNS Health (Manhattan, NY)
- …term services and supports, etc.. Consults with the member, family, providers and health plan departments as necessary. Identifies and communicates key points ... Review Entities and Quality Improvement Organizations. + Collaborates with professionals, health plan departments such as Claims and Medical Management,… more
- LA Care Health Plan (Los Angeles, CA)
- …overall coordination of the Appeals & Grievance (A&G) program for LA Care Health Plan members under the direct supervision and management of the A&G Nurse ... Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical Department: CSC...(Mid.) - $107,498.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency… more
- Molina Healthcare (Madison, WI)
- …proceedings, leading local appeal committee meetings. + Recruit and train members of the plan 's Local Appeal and Grievance Committee. + Grievance and Appeals ... **Job Description** **Job Summary** The Specialist , Member Rights serves as a member advocate...teams (IDTs). Maintains and manages an accessible appeals and grievance system for members to utilize. **Essential Job Functions**… more
- Henry Ford Health System (Grand Blanc, MI)
- …emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans ... as needed. As a strategic partner, the Labor Relations Specialist provides HR and Labor Relations support to leaders...within their designated areas, on behalf of Henry Ford Health at multiple sites. This support will include alignment… more
- Elevance Health (Norfolk, VA)
- **Title: Plan to Plan Service Specialist I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Plan to Plan Service Specialist ...service and manages adjustments, ITS processing, keying, rate negotiation, grievance and appeals, escalations, etc., in providing a seamless… more
- Cumberland River Behavioral Health, Inc. (Pineville, KY)
- Job Title: Recovery Services Peer Support Specialist Must have good oral and written communication skills. The peer specialist , who is or has been a recipient of ... competent, and continuous supports and services. It is essential the peer specialist have skills and competence to establish supportive trusting relationships with… more
- LA Care Health Plan (Los Angeles, CA)
- …Range: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC...County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million… more
- New York State Civil Service (Schenectady, NY)
- …College Savings Plan . * Voluntary pre-tax savings programs such as Health Care Spending Account and the Dependent Care Advantage Account offer employees options ... Agency People With Developmental Disabilities, Office for Title Human Resources Specialist 1/Trainee 1/2 (NY HELPS) Occupational Category Administrative or General… more
- CVS Health (Phoenix, AZ)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in...preferably** **Position Summary** Collaborate with a team specializing in Grievance and Appeals systems. Respond to incoming calls from… more
- University of Pennsylvania (Philadelphia, PA)
- …professional development opportunities, supportive work and family benefits, a wealth of health and wellness programs and resources, and much more. Posted Job Title ... Senior Staff and Labor Relations Specialist (Hybrid Eligible) Job Profile Title Labor and Staff...for assisting in and developing a comprehensive labor relations plan for the University as well as assisting in… more
- Montana State University-Northern (Havre, MT)
- …paid health insurance for employee with immediate coverage, Retirement plan with employer match, One floating holiday per year available immediately, Paid ... Recruiting Specialist Below you will find the details for...Policy defines and prohibits protected-class misconduct, and the Discrimination Grievance Procedures set forth the University's processes for addressing… more
- State of Georgia (Fulton County, GA)
- …satisfaction and work/life balance. Eligible employees are offered generous benefits, including health and dental insurance; retirement and savings plan options; ... Sr. Employee Relations Specialist Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/58617/other-jobs-matching/location-only) Human Resources… more
- University of Utah (Salt Lake City, UT)
- …**Open Date** 10/18/2024 **Requisition Number** PRN40120B **Job Title** Human Resources Specialist **Working Title** Employee Relations Specialist **Job Grade** ... University of Utah Human Resource Management ( UHRM ) Human Resources Specialist will engage in the development, planning, and implementation of employee relations… more
- Urbandale Community School District (Urbandale, IA)
- JOB TITLE: Behavior Specialist CLASSIFICATION: Classified FLSA STATUS: Exempt IMMEDIATE SUPERVISOR: Coordinator of Special Education RECEIVES GUIDANCE FROM: ... severe behaviors that require intensive support and intervention. The behavior specialist will build capacity of staff through training, coaching, and modeling… more
- Hoffman Construction Company (Portland, OR)
- Position Summary: The Union Labor Relations Specialist will work with the Operations Team and will report to the Executive VP of Operations. This position serves a ... affiliate companies with represented employees. The Union Labor Relations Specialist is responsible for interpreting, managing, and facilitating union collective… more
- Kelsey-Seybold Clinic (Houston, TX)
- …in area of specialization **Experience** Required: 5 years utilization review experience at a health plan , ACO, IPA, or provider group or 3 years clinical ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to determine… more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- Summary The Supervisory Program Specialist position is located in the Environmental Management Service at the Jesse Brown VA Medical Center, Chicago, IL . The ... personnel administration including knowledge of personnel operations, position classifications, grievance procedures, performance standards, functional statements, scopes of practice… more