- Elevance Health (Columbus, OH)
- ** Manager II Grievance / Appeals - Claims Support** This position will work in a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of one of our PulsePoint locations. The ** Manager II Grievance / Appeals ** is responsible...Capabilities and Experiences** : * BA/BS preferred. *Medicaid experience * RN _For URAC accredited areas, the following professional competencies… more
- VNS Health (Manhattan, NY)
- …requirements. Also monitors and audits subcontractors who have delegated responsibility for managing grievance and appeals on behalf of the plan to ensure ... collection systems and prepares data reports and analysis of grievance and appeals for program management and...+ License and current registration to practice as a registered professional nurse in New York State… more
- Elevance Health (Rancho Cordova, CA)
- ** Nurse Appeals - Licensed RN Nurse ** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the ... PulsePoint locations. **Shift:** Monday to Friday from 8:00-5:00 pm PT The ** Nurse Appeals ** is responsible for investigating and processing medical necessity… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** **Position Summary:** Reporting to the Director of Appeals & Grievances, the Manager , Appeals & Grievances (A&G) Audit ... Appeals & Grievances Department and delegated entities. The manager will work to ensures complaints and complex issues...+ Develop and execute on strategic opportunities to improve appeals & grievance process to support a… more
- Elevance Health (Los Angeles, CA)
- ** Nurse Appeals - California candidates only** **Location: This is a virtual position and prefer candidates reside within 50 miles of an Elevance Health ... the requisition.** **Schedule: Tuesday - Saturday 9:00am to 5:30 pm PST.** The ** Nurse Appeals ** is responsible for investigating and processing and medical… more