- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Supervisor , Grievances & Appeals is an inventory based role, supporting a team of ... This position will also support quality related go The Supervisor , Grievances & Appeals is an inventory...consumer experiences **Preferred Qualifications** + Previous experience working in Grievance and Appeals + Beginner knowledge in… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor (RN) directs and coordinates the accurate implementation of the clinical appeal process ... 3 years supervisory experience Utilization Management, and Government Program experience with Appeals and Grievance , Experience with MCG, InterQual, NCD and… more
- LA Care Health Plan (Los Angeles, CA)
- …Grievances is responsible for assisting with the development of a successful and cohesive Appeals and Grievance unit, with a high level of productivity to ... and/or exceed member satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring work, providing feedback on… 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, US, ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member… more
- Conduent (Hamilton, NJ)
- …and Health Services (DMAHS) of New Jersey. **Reports To** This position reports to the Appeals Supervisor and the Appeals Manager. The Appeals Manager ... individuality is noticed and valued every day. Fair Hearing Appeals Agent $18.50/ Hourly Onsite- Hamilton, NJ Full-time and...assistance for medical services may appeal Fair Hearing or Grievance decisions to which they were denied coverage, or… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Authorization Technician Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... the safety net required to achieve that purpose. Job Summary The Supervisor , Authorization Technician supports the Utilization Management (UM) Specialist by handling… more
- Independent Health (Buffalo, NY)
- …ICD-9-CM, ICD-10-CM and HCPCS coding preferred. + Experience in Compliance regulations, appeals and grievance knowledge preferred. + Demonstrated ability to ... Respectful, Trustworthy, Collaborative and Accountable. **Essential Accountabilities** Servicing and Grievance Appeal Team: + Research and respond to escalated and… more
- Missouri State University (Springfield, MO)
- …contrast to Administrative Assistants who provide administrative support services to a supervisor or for the department as a whole. The Administrative Specialist II ... maintenance and use of University assets, issue permits, process parking tickets and appeals , etc. Description of Primary Duties This position will serve as a member… more
- State of Colorado (Golden, CO)
- …team meetings in collaboration with CYSO III + Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, ... are applying. Incomplete employer information (address, phone number, and supervisor ) or omission of former employers may result in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- CDS Life Transitions (Webster, NY)
- …at least one of the following areas: call center operations, MLTC, grievance and appeals , and/or authorizations. Physical Requirements/Working Conditions: + Must ... timeframes, and proper procedures, ensuring errors are identified and corrected. Keeps supervisor apprised of any concerns or errors. + Document complaints in the… more
- Transportation Security Administration (Los Angeles, CA)
- …technical aspects of the work directed (employee relations principles and practices, appeals and grievance processes, OWCP, position management, staffing, human ... duty and FMLA issues. Supervisory/Managerial duties includes serving as a first line supervisor for the organization. This includes but is not limited to: assigning… more
- VNS Health (Manhattan, NY)
- …eligibility. + Coordinates with other departments, eg Care Management, Legal Affairs, Grievance and Appeals , Compliance, Membership Eligibility Unit, Quality as ... to the development of a safe member centered service plan + Consult with supervisor and others in overcoming barriers in meeting goals and objectives. + Maintains… more
- Johns Hopkins University (Baltimore, MD)
- …administration and analysis; benefits administration; employee relations (including grievance resolution, disciplinary action, reductions in force, termination); ... HR Director. + Gather sensitive information for the DOM HR Director, DOM for appeals , disciplinary actions and other personnel matters. + Assist DOM HR Director with… more
- CareOregon (Medford, OR)
- …Oregon Health Plan Fee For Service program benefits). + Report member complaints to Appeals and Grievance team for investigation and follow-up, per protocol. + ... (Community) Exemption Status Exempt Department Clinical Services Manager Title Care Team Supervisor Direct Reports n/a Requisition # 24581 Pay and Benefits Estimated… more