- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
- Insight Global (Los Angeles, CA)
- …by management: * Write determination letters regarding the outcome of non- clinical reviews/claim denials and send to the applicable participant/provider. Correspond ... by the examiners or Participant Services Representatives when necessary. * Assist Appeals Coordinator with preparation of Benefits Committee appeal cases. * Develop… more
- Spokane County (Spokane, WA)
- …as needed. + Oversees administrative management of the Grievance System, to include grievances , appeals and fair hearings. Identifies trends in Grievance System ... and attends community meetings as requested and approved by supervisor . + Provides clinical supervision and direction...requested and approved by supervisor . + Provides clinical supervision and direction to Housing and Community Support… more
- State of Colorado (Pueblo, CO)
- Occupational Therapist Supervisor - Therapist IV Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4506134) Apply Occupational Therapist ... Supervisor - Therapist IV Salary $98,000.00 Annually Location Pueblo,...care in groups or individualized treatment sessions + Provide clinical and administrative supervision to OT staff providing OT… more
- State of Colorado (Denver, CO)
- (Part Time) CORRECTIONAL, YOUTH, OR CLINICAL SECURITY OFFICER I - Denver 10:30 pm to 6:30 am Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4544643) Apply (Part Time) CORRECTIONAL, YOUTH, OR CLINICAL SECURITY OFFICER I - Denver 10:30 pm to… more
- Hackensack Meridian Health (Hackensack, NJ)
- …functions and performance improvement activities for the case managers. The Supervisor Case Management is accountable for the department's designated staff caseload ... case management process, including LOS, throughput, patient flow and denials and appeals follow up. i. Responsible for staff productivity and ongoing education. j.… more
- CVS Health (Columbus, OH)
- …but not limited to customer service, claim, provider services, complaints, grievances , and appeals , implementation, and/or plan sponsor operations. Executes ... service solution for large plan sponsors. Our embedded and customer-dedicated service, clinical , and rising risk pods allow maximization of inbound and outbound… more
- Commonwealth Care Alliance (Worcester, MA)
- …coordinate with relevant department(s) within CCA, or contracted IPAs + Assist members with appeals and grievances status, coordinate with Appeals and ... Exercised:** No **What You'll Be Doing:** + Answer incoming member calls for non- clinical issues and questions with the goal of first call resolution with each… more
- State of Colorado (Denver, CO)
- …youth, in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional or ... with the written program. Recommend any modifications of program to supervisory and/or clinical staff. Facilitate and monitor the cleanup of living units and rooms,… more
- CareOregon (Portland, OR)
- …following areas: Provider relations, managed care operations (eg, claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... Status Exempt Requisition # 24293 Direct Reports n/a Manager Title Provider Relations Supervisor Pay & Benefits Estimated hiring range $71,340 - $87,200, 7% lead… more
- CareOregon (Portland, OR)
- …following areas: Provider relations, managed care operations (eg, claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... Status Exempt Requisition # 24346 Direct Reports N/A Manager Title Provider Relations Supervisor Pay & Benefits Estimated hiring range $ 71,340 - $87,200 / year,… more
- Beth Israel Lahey Health (Westwood, MA)
- …information. Escalates calls to pharmacists for clinical inquiries and escalates grievances to supervisor . 7. Maintains new and existing patient profiles and ... Support health care providers with required prior authorization and required appeals . Manage all mail/delivery of Rx orders including addressing problems/issues with… more