- Centene Corporation (Phoenix, AZ)
- …member and provider complaints, grievances and appeals + Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals , claims or related managed care experience. Strong oral, written,… more
- VNS Health (Manhattan, NY)
- …to established procedures. Maintains confidentiality of information. + Maintains knowledge of Grievance and Appeals (G&A) procedures, and CMS and DOH regulatory ... health care organization required + Knowledge of DOH and CMS Grievance and Appeals regulatory requirements and procedures for ensuring compliance preferred +… more
- UCLA Health (Los Angeles, CA)
- Description The Appeals & Grievance Intake Coordinator serves as the primary point of contact for receipt of member-initiated complaints and Health Plan ... grievances and appeals . The Grievance and Appeals Intake Coordinator is responsible for managing the grievances and appeals shared email inbox and… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written ... complaints, grievances and requests for appeals that involve complex matters submitted by Members and...of all regulatory requirements as they apply to complaint, grievance and appeal processes. + Proficient in Microsoft applications,… more
- CVS Health (Frankfort, KY)
- …of responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance . Identify trends and emerging issues and ... report and recommend solutions. -Research incoming electronic appeals , complaints and grievance to identify if appropriate for unit based upon published business… more
- CoreCivic (Leavenworth, KS)
- …and a responsibility to better the public good. We are currently seeking a ** Grievance Coordinator ** who has a passion for providing the highest quality care ... dedicated to making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures… more
- CVS Health (Springfield, IL)
- …affordable. **Position Summary** Coordinate effective resolution of member or provider/practitioner appeals . Responsible for managing to resolution of appeals , ... may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach...work items that do not meet appeal, complaint and grievance criteria as well as identify trends in misrouted… more
- State of Massachusetts (Boston, MA)
- …Office of Health and Human Services (EOHHS) is seeking a Labor Relations Coordinator for the Health Human Resources Office.Our ideal candidate is an experienced ... recommendations concerning changes as needed. Receives,logsandmaintainsgrievances, DLR and other litigation/ appeals and refers toappropriate Laborstaff. Assists the Director, through… more
- UCLA Health (Los Angeles, CA)
- …Additional areas of responsibility include tracking and trending complaint and grievance data to identify and report aberrant trends. Key responsibilities include: ... + Analyze and resolve complaints/ appeals : Gather and organize key information, ensuring a thorough review. Consult with Medical Directors as needed to finalize… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …and brings employee relations matters to final resolution. Manage the staff appeals processes. * Partner with the Office of General Counsel, Institutional ... as needed. * Advise/refer faculty and staff on appropriate grievance procedures; advise managers/supervisors on required corrective action procedures; review,… more