- Sharp HealthCare (San Diego, CA)
- …as needed.Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight...needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'… more
- Centene Corporation (Jefferson City, MO)
- …division of financial responsibility interpretation, contract rate and language interpretation, appeals , grievances and eligibility. + Serve as primary point ... groups, and/or ancillary providers within assigned area. + Act as account manager for assigned groups acting as gatekeeper for interactions with other internal… more
- CHS (Clearwater, FL)
- …client trust. * Investigates and participates in formal responses relating to complaints, grievances and appeals received by or applicable to PAS. Participates ... **Overview** **Claims Manager ** **Servicing** **Health Insurance Policies or Benefits** **Summary:**...as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with… 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
- Sharp HealthCare (San Diego, CA)
- …+ Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief...the ability to interface effectively with employees, members, physicians, senior management, and the public at large. + Management… more
- Somatus (Mclean, VA)
- …Special Need Plans (SNPs). The Director, Quality will work closely with Sr. Manager , Audit Risk and the Regulatory and Accreditation Team to ensure compliance with ... audits, complaints/ grievances , and adherence to contractual obligations and Service Level...pre-delegation audits, annual client audits, development of grievance and appeals workflow processes, and other regulatory requirements. + Direct,… more