- VNS Health (Manhattan, NY)
- …issues pertaining to State Fair Hearings. Attends Fair Hearings in person with the Grievance and Appeals ' RN Specialist and presents arguments in defense ... + Enters data and assists with compiling reports and analysis on the grievance and appeals process. For Fair Hearings: + Supports Grievance and Appeals… more
- VNS Health (Manhattan, NY)
- …criteria. + Enters data and assists with compiling reports and analysis on the grievance and appeals process. + Participates in special projects and performs ... experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required +… more
- Robert Half Accountemps (Long Beach, CA)
- Description We are seeking an experienced Medical Grievances and Appeals Specialist to join our dynamic team. The successful candidate will be responsible for ... and regulations. + Provide educational assistance to members regarding the grievance and appeals process. + Ensure record keeping system is maintained and… more
- Commonwealth Care Alliance (Boston, MA)
- …to appeal and grievances. **What You'll Be Doing:** - Processing of Grievances & Appeals . - Responsible for the progress of grievance and appeal intervention and ... pharmacy, dental, reporting, and member services. - Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day tasks and assignments.… more
- LA Care Health Plan (Los Angeles, CA)
- …meet and/or exceed member satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring work, providing ... assisting with the development of a successful and cohesive Appeals and Grievance unit, with a high...and or process improvement. Assist Supervisor to ensure that Specialist provide accurate, timely, and quality responses. Ensure that… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- BayCare Health System (Clearwater, FL)
- …be working remotely? Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Grievance Specialist -Health Plan **Location** Clearwater:Park Place | ... to regulatory requirements. + Triage, plan, and execute intake of Appeals and Grievance submissions. + Keeping track of deadlines, ensuring all necessary… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and ... grievance process that meets state, federal, accreditation and other...knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests,… more
- Molina Healthcare (Madison, WI)
- …and problem solving with interdisciplinary teams (IDTs). Maintains and manages an accessible appeals and grievance system for members to utilize. **Essential Job ... **Job Description** **Job Summary** The Specialist , Member Rights serves as a member advocate...and train members of the plan's Local Appeal and Grievance Committee. + Grievance and Appeals… more
- Bassett Healthcare (Cooperstown, NY)
- …Committee, Medical Staff Leadership and additional ad-hoc reports as requested. Coordinates the grievance appeals with the Medical Director as needed. Develop a ... manner in accordance with the governing standards, rules and regulations. The Specialist is responsible for the complaint/ grievance process throughout the… more
- Maryland Department of Transportation (Baltimore City County, MD)
- Labor Relations Specialist (Administrator III) Salary $69,323.00 - $112,044.00 Annually Location Baltimore City Job Type Full Time Job Number ... + Benefits + Questions Description MARYLAND TRANSIT ADMINISTRATION Labor Relations Specialist (Administrator III) (2588) Grade 18 Career Service Open to all… more
- Henry Ford Health System (Grand Blanc, MI)
- …facilities and locations as needed. As a strategic partner, the Labor Relations Specialist provides HR and Labor Relations support to leaders and associates within ... active participation in the negotiations of collective bargaining agreements, manage grievance procedures to handle complaints from unionized employees, and advise… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- HUMAN RESOURCES ANALYST C OR SPECIALIST Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4706651) Apply HUMAN RESOURCES ANALYST C OR ... SPECIALIST Salary $3,570.67 - $6,689.00 Monthly Location Baton Rouge,...or other actions on new and/or updated position descriptions, appeals for reallocation and related transactions. + Submits requested… more
- Elevance Health (Norfolk, VA)
- …of customer service and manages adjustments, ITS processing, keying, rate negotiation, grievance and appeals , escalations, etc., in providing a seamless Blue ... **Title: Plan to Plan Service Specialist I** **Location:** This position will work a...internal business partners (sales, member experience, claims, medical review, appeals , etc.) and external contacts within the other Blues… more
- Montana State University (Bozeman, MT)
- …please contact: Laura Larsson ###@montana.edu ### Classification Title Student Support Specialist Working Title CO-OP Student Success Specialist Brief Position ... for the Caring for Our Own Program (CO-OP), the CO-OP Student Success Specialist is responsible for guiding students from prospective status through enrollment at… more
- City and County of San Francisco (San Francisco, CA)
- …members of the public or as elevated through the Citywide ADA Grievance procedure or other responsive complaints mechanisms. Develop recommendations for barrier ... right of ways. Substitution: possession of a Certified Access Specialist (CASp) certification through the CA Division of the...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- Missouri State University (Springfield, MO)
- Posting Details Position Information Position Title Administrative Specialist II (Office of University Safety) Work Location Springfield Campus Department Office of ... Type Full Time Regular Exempt/Non-Exempt Non-Exempt General Function The Administrative Specialist II works in depth with programs, processes, or services that… more
- Elevance Health (Overland Park, KS)
- …for incidents involving suspected abuse, neglect, or exploitation. + Makes a referral to Grievance and Appeals when a potential quality of care concern is ... of members. + Collaborates with Network Relations, Quality, and Grievance and Appeals on identifying and supporting...the care coordination team in coordination with the training specialist in recognizing and screening for signs of abuse,… more
- State of Colorado (Canon City, CO)
- …at the informal level; + Ensures staff compliance with the offender grievance process, offender co-pay, electronic data entry, and information systems requirements; ... Administrative Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel Director's Administrative… more