• Manager, Grievance and Appeals, RN

    VNS Health (Manhattan, NY)
    …the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our grievance ... timely processing for the Medicare and Medicaid appeal and grievance processes, incidents, quality of care concerns and any...are educated and compliant with requirements of appeals and grievance regulations and processing. + Work closely with all… more
    VNS Health (03/05/25)
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  • ADC Inmate Grievance Coordinator

    State of Arkansas (Dermott, AR)
    ADC INMATE GRIEVANCE COORDINATOR Date: May 1, 2025 Req ID: 49116 Location: Dermott, AR, US, 71638 Category: DEPARTMENT OF CORRECTION Anticipated Starting Salary: ... - $51,686.00 Summary The Arkansas Department of Corrections (ADC) Inmate Grievance Coordinator is responsible for investigating and documenting inmate grievances at… more
    State of Arkansas (05/02/25)
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  • Grievance Analyst (Quality Assurance)

    CVS Health (Phoenix, AZ)
    …an exciting new opportunity within the Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for performing quality reviews on various ... grievance processes to ensure all tasks are completed according...the highest expectations for a positive member experience. The grievance processes requiring review will encompass all grievance more
    CVS Health (04/25/25)
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  • Appeals & Grievance Analyst

    Point32Health (MA)
    …communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible ... and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works collaboratively with… more
    Point32Health (05/01/25)
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  • Patient Safety/ Grievance Program Manager…

    Texas Health Resources (Arlington, TX)
    Patient Safety/ Grievance Program Manager - TH Urgent Care (Breeze), Full-time, Days _Bring your passion to Texas Health so we are Better + Together_ Work location: ... Patient Safety Risk Department: Looking to fill a dedicated Patient Safety-Risk/ Grievance position that facilitates all patient safety and clinical risk management… more
    Texas Health Resources (04/18/25)
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  • Member Appeals and Grievance Intake…

    Fallon Health (Worcester, MA)
    …and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with CMS regulations, ... applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH Appeals and … more
    Fallon Health (04/15/25)
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  • Grievance /Appeals Analyst Lead

    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 but ... to work in the office quarterly.** **Schedule: Monday-Friday 8am-5pm EST** The ** Grievance /Appeals Analyst Lead** is responsible for leading and coaching a team of… more
    Elevance Health (04/12/25)
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  • Grievance Coordinator

    CoreCivic (California City, CA)
    …and a responsibility to better the public good. We are currently seeking a ** Grievance Coordinator** who has a passion for providing the highest quality care in an ... to making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures that both… more
    CoreCivic (04/09/25)
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  • Grievance Examiner

    Liberty Healthcare Corporation (Rushville, IL)
    A full-time Grievance Examiner position is now available with Liberty Healthcare Corporation at the Illinois Department of Human Services Treatment & Detention ... Social Workers, Counselors, Psychiatrists, Recreation Therapists, and ancillary professionals. As a Grievance Examiner with Liberty at the TDF, you will enjoy an… more
    Liberty Healthcare Corporation (04/29/25)
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  • Grievance & Appeals Specialist, Clinical

    VNS Health (Manhattan, NY)
    …maintains accurate records documenting the actions and rationale for each grievance or appeal decision. Develops correspondence communicating the outcome of ... and assists with compiling reports and analysis on the grievance and appeals process. + Participates in special projects...care, including a minimum of two years in a grievance and appeals or related area such as medical… more
    VNS Health (02/07/25)
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  • Grievance Analyst (Caseworker)

    CVS Health (Phoenix, AZ)
    …new opportunity within the Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for researching, resolving, and communicating any ... Management (PBM) or pharmaceutical related industry. - Previous Med D grievance experience. - Bachelors Degree Preferred. **Education** High School Diploma or… more
    CVS Health (04/29/25)
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  • Appeals and Grievance Coord

    Baylor Scott & White Health (Temple, TX)
    **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written complaints, ... current knowledge of all regulatory requirements as they apply to complaint, grievance and appeal processes. + Proficient in Microsoft applications, including Word… more
    Baylor Scott & White Health (04/18/25)
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  • Senior Coordinator, Grievance & Appeals

    VNS Health (Manhattan, NY)
    …established procedures. Maintains confidentiality of information. + Maintains knowledge of Grievance and Appeals (G&A) procedures, and CMS and DOH regulatory ... in a health care organization required + Knowledge of DOH and CMS Grievance and Appeals regulatory requirements and procedures for ensuring compliance preferred +… more
    VNS Health (03/07/25)
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  • Lead Grievance & Appeals Coordinator

    Centene Corporation (Phoenix, AZ)
    …Bachelor's degree in related field or equivalent experience. 2+ years of grievance and appeals experience in a Healthcare or Managed Care setting. *Prefer ... claims and prior leadership experience. **Location: Position is remote. However, travel to the Tempe, AZ office may be necessary.** Pay Range: $22.79 - $38.84 per hour Centene offers a comprehensive benefits package including: competitive pay, health… more
    Centene Corporation (04/27/25)
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  • Appeals and Grievances Triage Administrator…

    Fallon Health (Worcester, MA)
    …visit fallonhealth.org. **Brief Summary of Purpose:** Fallon Health's (FH) Appeals and Grievance process is an essential function to FH's compliance with CMS ... and Grievances Triage Administrator serves to administer the FH Appeals and Grievance process as outlined in the FH Member Handbook/Evidence of Coverage,… more
    Fallon Health (03/26/25)
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  • Hearing Officer

    TAD PGS, Inc. (Chicago, IL)
    …of management, serving as hearing officer or mediator for union grievance hearings, resolution meetings, and other labor/management activities. Aids Labor Counsel ... to arbitrations and other labor-related litigation. Research information from past grievance files, personnel records, salary grades of specific union job… more
    TAD PGS, Inc. (03/14/25)
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  • Sr Labor Relations / Employee Relations Partner

    Southern Glazer's Wine and Spirits (Fort Worth, TX)
    …for maintaining and enhancing positive employee relations. Leads employee and grievance investigations and implementation of employee and labor relations strategies ... Manager, Employee and Labor Relations. **Primary Responsibilities** * Lead employee, grievance , and policy investigations for assigned client group. * Provide… more
    Southern Glazer's Wine and Spirits (02/20/25)
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  • Sr. Quality and Safety Specialist

    University of Rochester (Rochester, NY)
    …Department to determine if patient complaints require follow-up according to the grievance process. + Communicates directly with patients and families to manage ... identified grievance issues and follow-up during the grievance process. Coordinates review of quality grievance issues with involved Hospital departments and… more
    University of Rochester (02/12/25)
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  • Substitute Teacher Associate

    Fairfield Community School District (Fairfield, IA)
    …in its educational programs and its employment practices. There is a grievance procedure for processing complaints of discrimination. If you have questions or ... a grievance related to this policy please contact the district's...educational programs and its employment practices. There is a grievance procedure for processing complaints of discrimination. If you… more
    Fairfield Community School District (05/01/25)
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  • Lead Union Negotiator - HR Labor / Employee…

    FirstEnergy (Greensburg, PA)
    …achieve cost effective and competitive labor agreements, contract administration, grievance and arbitration administration and preparation. This position also ... Remote **Responsibilities:** + Negotiating collective bargaining agreements + Managing the grievance and arbitration process to ensure thorough, timely and effective… more
    FirstEnergy (04/30/25)
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