- VNS Health (Manhattan, NY)
- …navigating the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the daily operations ... of our grievance and appeals processes. You will play a crucial role in...Relations, Claims, Medical Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and… more
- Fallon Health (Worcester, MA)
- …us on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance ... standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH… more
- Elevance Health (Tampa, FL)
- ** Grievance / Appeals Analyst Lead** **Candidates must be located within 50 miles an Elevance Health PulsePoint office. This position is primarily work from home ... you to work in the office quarterly.** **Schedule: Monday-Friday 8am-5pm EST** The ** Grievance / Appeals Analyst Lead** is responsible for leading and coaching a… more
- Fallon Health (Worcester, MA)
- …For more information, visit fallonhealth.org. **Brief Summary of Purpose:** Fallon Health's (FH) Appeals and Grievance process is an essential function to FH's ... FH Appeals and Grievances Triage Administrator serves to administer the FH Appeals and Grievance process as outlined in the FH Member Handbook/Evidence of… more
- HCA Healthcare (Rochester, NH)
- …nurses set us apart from any other healthcare provider. We are seeking aCase Manager to join our healthcare family. **Currently offering sign on bonus up to $10k** ... - and empowers their passion for patient care. Apply today for our Case Manager opportunity. **Job Summary and Qualifications** The Case Manager is responsible… more
- University of Delaware (Newark, DE)
- Manager , Employee & Labor Relations Job no: 501883 College / VP Area:Office of Human Resources Work type: Staff Location: Newark/Hybrid Categories: Human Resources, ... Director, Employee and Labor Relations, the Employee and Labor Relations Manager , is responsible for managing day-to-day employee and labor relations functions.… more
- MTA (Jamaica, NY)
- Senior Manager , Labor Relations Job ID: 11392 Business Unit: MTA Headquarters Location: Jamaica, NY, United States Regular/Temporary: Regular Department: Labor ... Posted: Apr 15, 2025 Description POSTING NO. 11392 JOB TITLE: Senior Manager , Labor Relations DEPT/DIV: Labor Relations WORK LOCATION: Jamaica, NY FULL/PART-TIME FUL… more
- State of Colorado (Chaffee County, CO)
- CDOC Corrections Case Manager I (Buena Vista) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4921223) Apply CDOC Corrections Case Manager ... providing opportunities for offenders to receive feedback, crisis intervention, and grievance resolution; + Stresses results oriented direction in guiding offender… more
- VNS Health (Manhattan, NY)
- …eligibility. + Coordinates with other departments, eg Care Management, Legal Affairs, Grievance and Appeals , Compliance, Membership Eligibility Unit, Quality as ... a Registered Professional Nurse in New York State required + Certified Case Manager preferred Education: + Bachelor's Degree in nursing or equivalent work experience… 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
- Skookum Contract Services (Bremerton, WA)
- …with union officials and adheres to terms of labor contract by supporting Manager in the day-to-day implementation of policies concerning wages, hours, and working ... relation issues and concerns, union issues, classification, performance management, grievance resolution, leave of absence coordination, disability accommodation(s), Fitness-for-duty… more
- New York State Civil Service (Albany, NY)
- …relations and employee relations.* Assisting in scheduling and conducting grievance meetings, investigations, interviewing, interrogations to identify and report ... issues.* Assisting in providing advice and consultation to supervisors, manager , directors, and Executives ensuring proper interpretation and administration of… more
- State of Colorado (Canon City, 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
- Loretto Management Corporation (Syracuse, NY)
- …deems the equipment is no longer necessary. + Responsible for explaining PACE CNY's grievance and appeals process to participants. + Repairs any broken DME, ... Overview The Durable Medical Equipment (DME) Specialist assists DME Manager in the daily operations of the DME department....daily DME schedules as outlined by the DME Principal Manager . The schedules include delivery of supplies to meet… more
- Elevance Health (Columbus, OH)
- …including assessments, service planning, care coordination, transition planning, member appeals , state hearings, and member and caregiver education and training. ... in accordance with federal and state requirements, overseeing the member grievance process. + Work closely with Medical Officers, Quality Directors, Providers,… more
- Louisiana Department of State Civil Service (New Orleans, LA)
- …Received: Direct from a Human Resources Supervisor, Human Resources Manager , or higher level administrative official. Supervision Exercised: May supervise ... liaison on unemployment claims, providing information and assistance as needed, including appeals documents and representing the agency during a hearing + Advises… more
- Elevance Health (Indianapolis, IN)
- …necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Elevance Health (Houston, TX)
- …of 2 years related experience preferably in healthcare insurance departments such as Grievance and Appeals , Contracting or Claim Operations, law enforcement; or ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Elevance Health (Chicago, IL)
- …necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
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