- Evolent (Columbus, OH)
- …is required. + Minimum of 5 years in Utilization Management, health care Appeals , compliance and/or grievances /complaints in a quality improvement environment is ... for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of… more
- Elevance Health (Tampa, FL)
- …school diploma or GED equivalent and a minimum of 3 years of Grievance & Appeals Senior analyst experience; or any combination of education and experience which ... review, analyze and process pre service and post service grievances and appeals requests related to clinical...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- 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
- 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, ... of the Job: Under the limited direction of the Senior Director, Employee and Labor Relations, the Employee and...Employee and Labor Relations, the Employee and Labor Relations Manager , is responsible for managing day-to-day employee and labor… 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
- Ventura County (Ventura, CA)
- …agencies as needed; + Serves as the compliance point of contact for grievances , appeals , and Notices of Adverse Benefit Determinations (NOABDs); + Supervises ... Behavioral Health Compliance Manager Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4774428) Apply Behavioral Health Compliance Manager … more
- Guardian Life (Holmdel, NJ)
- …contact for all assigned DSOs. Respond to provider inquiries, concerns, complaints, appeals and grievances within assigned timeframes. Collaborate across teams ... Organization (DSO) partners. As a **Key DSO Dental Account Manager , Dental Support Organizations** , you will be responsible...financial reimbursement rates with DSOs + Make presentations to senior -level management of DSOs + Identify and report to… more
- State of Colorado (Denver, CO)
- …and guidance on issues that relate to performance management, progressive discipline, employee grievances and appeals , and civil rights. You will also be the ... delivering HR-related training; + SHRM Certified Professional (SHRM-CP) or SHRM Senior Certified Professional (SHRM-SCP) credential, SPHR, or PHR; + Proven… more
- MTA (New York, NY)
- …ensures effective and timely processing of investigations, pre-trial conferences, trials, union appeals and assists with answering grievances . The position is ... charged with providing advice to department heads and senior staff to ensure the consistency and standardization of dispute resolution among the various departments… more
- Customs and Border Protection (Laredo, TX)
- …services. Your typical duties will include: Serving as an office manager and providing administrative analytical support for the organization Developing, devising, ... of issues/problems concerning functions that are the responsibility of the manager , schedules appointments and make all necessary arrangements for travel, meetings,… 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
- Point32Health (Canton, MA)
- …including but not limited to P&T, DCC, MAD, Management team meetings, Appeals & Grievances , Quality Performance Improvement Team (QPIT). + Direct ... service to our members, partners, colleagues and communities. **Job Summary** The Senior Clinical Pharmacist is responsible for the development and maintenance of… more
- LA Care Health Plan (Los Angeles, CA)
- …care setting. Experience in health care auditing and monitoring (preferably in Appeals , Grievances , Quality Improvement, Utilization Management (UM) and so ... for the Regulatory Compliance unit, the Advisor also advises and supports the Manager , Director, and Chief Compliance Officer on other duties as assigned to support… more
Related Job Searches:
Appeals,
Appeals Grievances,
Appeals Manager,
Grievances,
Manager,
Manager Appeals Grievances,
Senior,
Senior Manager