- Commonwealth Care Alliance (Boston, MA)
- …pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day tasks and ... Processing of Grievances & Appeals: + Responsible for the progress of grievance and appeal intervention and resolution. + Assure verbal and written responses… more
- Centene Corporation (Phoenix, AZ)
- …Purpose:** Analyze and resolve verbal and written claims and authorization grievance /appeals from providers and members. Resolve all State inquires related to ... state and organizational regulations and policies and procedures + Review claim grievance for reconsideration and either approve/deny based on determination level or… more
- Centene Corporation (Phoenix, AZ)
- …Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals Committee + Support the pay-for-performance programs, including data ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral,… more
- Centene Corporation (Phoenix, AZ)
- …Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals Committee + Support the pay-for-performance programs, including data ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral,… more
- Robert Half Accountemps (Los Angeles, CA)
- …A Medical IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist. The Grievance & Appeals Specialist, will be in responsible ... resolving denied claims, complying with State/Federal laws, rules, and guidelines. The Grievance & Appeals Specialist will be expected to perform research and… more
- HCA Healthcare (Round Rock, TX)
- …each individual is recognized. Submit your application for the opportunity below: Coordinator Patient SafetySt. David's Round Rock Medical Center **Benefits** St. ... benefits may vary by location._** We are seeking a(an) Coordinator Patient Safety for our team to ensure that...the patient safety department in the maintenance of the grievance process, the patient safety event surveillance system to… more
- Marion Independent School District (Marion, IA)
- …or a grievance related to this policy please contact: Equity Coordinator (for employment), Janelle Brouwer, Superintendent, 777 South 15th Street, Marion Iowa, ... AP Coordinator MHS JobID: 1127 + Position Type: Athletics/Activities/...registration materials and student handbooks The District has established grievance procedures for processing complaints of discrimination. If you… more
- CVS Health (Sacramento, CA)
- …load including but not limited to:-Research incoming electronic appeals, complaints and grievance to identify if appropriate for unit based upon published business ... reroute inappropriate work items that do not meet appeals, complaints and grievance criteria. + Research Standard Plan Design or Certification of Coverage (Evidence… more
- Minnesota State (St. Paul, MN)
- …Closing Date (if designated).** **Working Title:** Student Conduct and Investigations Coordinator - MnSCU Academic Professional 2 **Institution:** Saint Paul College ... Director of Equity and Belonging, the Student Conduct and Investigations Coordinator provides overall leadership, coordination and management of Saint Paul College's… more
- Shelter Association of Washtenaw County (Ann Arbor, MI)
- SAWC Mental Health Coordinator Description Reports to: Program Director The Shelter Association of Washtenaw County is committed to creating a diverse environment ... person at a time. Position Profile: The Mental Health Coordinator assists in guiding and mentoring shelter staff in...resources, as appropriate to client needs. 5. Co-facilitate the Grievance Committee and offer client follow up and engagement.… more
- Geisinger (Danville, PA)
- Job Summary Provides support in administration of the Appeals and Grievance process. Serves as a liaison between Members and the Plan with appeals regarding denied ... tracking database. + Ensures that all complaint, appeal and grievance time frames are met as dictated by guidelines...as the primary resource regarding the complaint, appeal and grievance processes to all other Health Plan and external… more
- Roper St. Francis (Charleston, SC)
- …Day shift 8:00am-5:00pm** **Job Summary** **:** The Patient Relations & Legal Coordinator aids in complaints and grievances management as well as legal matters ... resolutions, receives & forwards compliments, issues acknowledgement letters, forwards grievance forms within the designated timeframe, assists with accreditation… more
- International Rescue Committee (Oakland, CA)
- Requisition ID: req58658 Job Title: Preferred Communities Coordinator Sector: Social Work Employment Category: Regular Employment Type: Full-Time Compensation: USD ... communities in the Bay Area. Job Overview The Preferred Communities (PC) ( Coordinator will address barriers to safety and wellness under ORR's Preferred Communities… more
- University of Colorado (Denver, CO)
- **Bilingual Operations Coordinator ** **University of Colorado Denver** Bilingual Operations Coordinator -36679 University Staff **Description** **University of ... Medical Campus** **Department:College of Nursing** **Job Title: Bilingual Operations Coordinator ** **Position Location: Sheridan Health Services** **_3525 W. Oxford… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Coordinator of Patient Experience - FT Days - Monday - Friday** **Position Summary:** In ... with the Mission, Vision and Values of St. Peter's Heath Partners, the Coordinator of Patient Experience contributes to the day-to-day functions related to the… more
- Peak Vista (Colorado Springs, CO)
- Compliance & Risk Coordinator Summary Title:Compliance & Risk Coordinator ID:0619-5716 Department Location:3205/3207 N. Academy, Colorado Springs, CO 80917 ... the direction of the Manager of Compliance and Risk Management, the Compliance/Risk Coordinator provides support to the Compliance & Risk department, and others as… more
- UPMC (Pittsburgh, PA)
- UPMC Community Care Behavioral Health is seeking a full-time Coordinator of Care Management to support the Adult Acute team within the Allegheny County Care ... Management Department! The Coordinator , Care Management will work standard hours, Monday through...in professional development activities. + Coordinates the complaint and grievance process for members. + Works with Network Management… more
- Hamline University (St. Paul, MN)
- …reasonable accommodations to qualified individuals with disabilities. **JOB SUMMARY** The Coordinator is responsible for managing the operations of the Campus Pride ... staff and faculty. This position works in collaboration with the Title IX Coordinator to coordinate all required training for the Hamline community and to assist… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Managed Care Outcomes Coordinator ** **Job Class: Human Services Program Representative 2** **Agency: Human Services Dept** + **Job ID** : 87867 + ... location to be eligible for telework.** The Managed Care Outcomes Coordinator is responsible for managed care organization (MCO) performance assessment,… more
- Hawaii Pacific Health (Honolulu, HI)
- …solving problems before they get out of hand. As the Patient Relations Coordinator , you will administer, manage and coordinate the resolution of patient relations ... patients can seek resolution to problems; coordinating the formal patient grievance process; and supporting all clinical entities within the designated facility.… more