- Elevance Health (Durham, NC)
- ** Manager II Grievance / Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... unless an accommodation is granted as required by law._ The ** Manager II Grievance / Appeals ** responsible for management oversight of grievances and … more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances...5 years of experience resolving health care eligibility, access, grievance and appeals issues, preferably in health… more
- Molina Healthcare (San Antonio, TX)
- …years' experience in healthcare claims review and/or Provider appeals and grievance processing/resolution, including 2 years in a manager role. * Experience ... Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member… more
- Molina Healthcare (St. Petersburg, FL)
- …7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, including 3 years in a manager role. * Experience ... for leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible for reviewing and resolving member and… more
- Point32Health (MA)
- …Point32Health (https://www.point32health.org/) . **Job Summary** Under the direction of the A&G Manager , the Appeals & Grievances QA Auditor audits the quality ... of letters and keyed entries from the Grievance and Appeals systems. Checks cases built by other associates to ensure highest level of quality and timeliness.… more
- Point32Health (MA)
- …Point32Health (https://www.point32health.org/) . **Job Summary** Under the general direction of the Manager , Appeals and Grievances the Supervisor, Appeals ... ensure all cases are processed timely. + Work with Manager to ensure that employees have the requisite information...+ Preferred: Experience + Required (minimum): 4-6 years of Appeals and Grievance experience.1-2 years of prior… more
- Transdev (North Las Vegas, NV)
- Labor Relations Manager The Labor Relations Manager provides support to the Area General Manager , Director of Human Resources, and Operations Teams on labor ... ensure consistency in language and interpretation of collective bargaining agreements, grievance management, and arbitration preparation. Transdev is proud to offer:… more
- CUNY (Brooklyn, NY)
- …assessment, BIT/student support case management, freedom of expression oversight, and grievance and appeals resolution. + Collaborate with various departments ... Manager of Student Advocacy and Accountability (HEA) **POSITION...conduct reports; coordinating the student conduct process, grievances, and appeals . + Oversee the Faculty Student Disciplinary Committee to… more
- MTA (Jamaica, NY)
- Senior Manager , Labor Relations & Arbitration Job ID: 11392 Business Unit: MTA Headquarters Location: Jamaica, NY, United States Regular/Temporary: Regular ... Date Posted: Jul 8, 2025 Description POSTING NO. 11392 JOB TITLE: Senior Manager , Labor Relations & Arbitration DEPT/DIV: Labor Relations WORK LOCATION: Jamaica, NY… more
- Sacramento County (Sacramento, CA)
- Human Services Division Manager Range A/B Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2234944) Apply Human Services Division Manager ... $12,042.50 - $14,636.88/month Under executive direction, the Human Services Division Manager plans, coordinates and administers a human services division comprised… more
- Humana (Springfield, IL)
- …with Medicaid or DSNP Members. + Knowledge and/or experience in working with grievance and appeals . + Intermediate to advanced knowledge of Microsoft Office ... strategies on matters of significance, and lead execution of member grievance and appeal trends, working closely with cross-departmental management. + Partners… more
- CVS Health (Olympia, WA)
- …(PO) is responsible for leading the Medicare innovation product development for the Grievance & Appeals (G&A) Department. This role contributes to the product ... vision and translates it for the product development team. They are responsible for team backlog development and prioritization, maintaining integrity of features or components, and collaborating closely with Engineering, Design, and other stakeholders. They… more
- Corewell Health (Grand Rapids, MI)
- …or advanced level using Microsoft Office Suite preferred + Previous experience with grievance and appeals processes. Preferred How Corewell Health cares for you ... Federal decisions are properly implemented. Assist the Lead, Supervisor and/or Manager in coordinating activities and in the development/collection of materials… more
- City of Stockton, CA (Stockton, CA)
- …in labor negotiations; provides strategic guidance to staff on disciplinary appeals , grievance /arbitration appeals and labor negotiations proposals. ... information to other agencies, human resource management, and/or the City Manager 's staff. + Provides direction for employee/labor relations functions by researching… more
- Sharp HealthCare (San Diego, CA)
- …Chief Medical Officer and reports findings in conjunction with the Quality Improvement Manager . + Participates in the grievance process with the Chief Medical ... policy as needed. + Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager to identify trends… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- …supervision of a Labor/Employee Relations Specialist or Labor/Employee Relations Manager , responsible for providing technical support within the Labor/Employee ... - May assist in resolving employee-management disputes, inquiries, and coordinate grievance procedures regarding worker complaints. May also offer input on issues… more
- Sharp HealthCare (San Diego, CA)
- …to Plan policy as needed.Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager to identify ... needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'...data of paid claims, encounters, authorization logs, complaint and grievance logs and other sources. + Achieves and maintains… more
- Roper St. Francis (Charleston, SC)
- …resolutions, receives & forwards compliments, issues acknowledgement letters, forwards grievance forms within the designated timeframe, assists with accreditation ... or healthcare preferred. Prior experience working with grievances and appeals strongly preferred. Knowledge of RSFH organizational structure strongly preferred.… more
- State of Colorado (CO)
- …referrals and consultations, medical reporting, medical co-signature and inmate grievance requirements are completed in accordance with DOC Administrative ... establish an eligible list for referral to the hiring manager for final consideration. Be sure the "Work Experience"...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- City of La Mesa, CA (La Mesa, CA)
- …documentation; assists in the administration of disciplinary hearing process and grievance appeals ; and works through discipline and termination procedures ... benefits are provided at the direction of the City Manager . The City Manager may periodically adjust the Management benefits package. Although Management… more