- Elevance Health (Costa Mesa, CA)
- **Title: Grievance/ Appeals Analyst I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... work-life integration, and ensures essential face-to-face onboarding and skill development. The **Grievance/ Appeals Analyst I** is an entry level position in the… more
- Highmark Health (Sacramento, CA)
- …of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals ; initiates a case file for each grievance and appeal; ensures ... all involved parties. + Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross… more
- CVS Health (Sacramento, CA)
- …each and every day. **Position Summary** Research and process grievances and appeals for Dual eligible members and providers. Perform outreach to obtain additional ... information. Interact with Medical Directors and Nurses as well as Leadership. **Required Qualifications** + 1 year of experience processing health insurance grievance and appeal cases. **Preferred Qualifications** + 6+ years of experience Medicare and… more
- LA Care Health Plan (Los Angeles, CA)
- Appeals & Grievances Regulatory Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This position is… more
- City and County of San Francisco (San Francisco, CA)
- …grants, contracts, budgets, finance, and/or program evaluation and planning. As an Administrative Analyst , you may work with a manager to perform research to develop ... the department. + Providing a real-world example, a Policy Analyst for the Office of the Treasurer & Tax...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …that may impact the department. + Providing a real-world example, a Junior Policy Analyst for the Office of the Treasurer & Tax Collector could involve working to ... partners. + Providing a real-world example, a Junior Budget Analyst may have the opportunity to learn about the...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …and County of San Francisco has to offer. As a Senior Administrative Analyst , you will be responsible for directing and performing challenging, complex, and ... operations. + Providing a real-world example, a Senior Contracts Analyst could assist with procurement and contract administration related...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …years of verifiable professional human resources experience, similar to 1241 Human Resources Analyst , in one or more of the following areas of activity: recruitment ... Additional qualifying work experience as a professional human resources analyst may be substituted for up to two years...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …improve financial performance and mitigate risks. The 1825 Principal Administrative Analyst II (Financial Reporting and Compliance Manager) will perform other ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...the online application was not submitted or received. Exam Analyst Information: If you have any questions regarding this… more
- City and County of San Francisco (San Francisco, CA)
- …. Under the general direction the 1054 IS Business Analyst Principal will serves as the technical authority for one ... staff, such as but not limited to IS Business Analyst , IS Engineers, Cable Splicers, etc. You are excited...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …County of San Francisco has to offer. In the role of Principal Administrative Analyst , you will lead and perform challenging and complex projects that span areas ... in this selection process, which includes the following: Administrative Analyst Core Exam (Weight: 60%) Candidates meeting the Minimum...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …We're Looking For Under administrative direction, the IS Principal Business Analyst at San Francisco Employees' Retirement System is responsible for coordinating ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...this recruitment or application process, please contact the exam analyst , James Galileo, at ###@sfgov.org. All your information will… more
- LA Care Health Plan (Los Angeles, CA)
- Business Analyst III Job Category: Claims Department: Claims Data and Support Services Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: ... net required to achieve that purpose. Job Summary The Business Analyst III facilitates business process improvement via the methodical investigation, analysis,… more
- The County of Los Angeles (Los Angeles, CA)
- DISASTER SERVICES ANALYST Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4684863) Apply DISASTER SERVICES ANALYST Salary $87,086.16 - ... attaching to your application or sending to the exam analyst . IMPORTANT NOTICE: Prime Variance Reports (PVRs), also known...to be a valid reason for an extension of appeals rights period. + I understand the above information.… more
- Sacramento Municipal Utility District (Sacramento, CA)
- Title: Principal Employee Relations Analyst Department: Employee Relations Location: Sacramento, CA, US, 95827-3824 Category: **Minimum Pay Rate:** $123,531.20 ... SMUD's People Services and Strategies Department seeks a Principal Employee Relations Analyst to provideprofessional and analytical support as well as subject matter… more
- Dignity Health (Bakersfield, CA)
- **Responsibilities** The Provider Data Analyst is responsible for the maintenance of the DHMSO Provider Data Network within EZCAP. The maintenance includes creating ... Contracting and Credentialing teams as needed when questions arise. The Provider Data Analyst partners with Configuration Claims and Enrollment to ensure end to end… more
- Evolent (Sacramento, CA)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Operational Analytics** The Operational Performance Analytics team, a part of ... Evolent's Analytics department, is seeking a Senior Analyst to collaborate cross-departmentally to help our organization gain efficiencies and drive decision-making… more
- Sutter Health (Sacramento, CA)
- …involves tracking and monitoring jurisdictional deadlines for filings, audits, appeals , mailing, and payment dates. Additionally, it includes researching tax ... issues, reconciling data, and working with local jurisdictions to verify calculations and methodologies. The position will also assist with property tax audits, assessment reviews, and participate in on-site inspections with local jurisdictions throughout… more
- City and County of San Francisco (San Francisco, CA)
- …examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service Commission. ... Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'...the online application was not submitted or received. Exam Analyst Information: If you have any questions regarding this… more
- City and County of San Francisco (San Francisco, CA)
- …examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service Commission. ... Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'...Microsoft Edge web browser to submit your application. Recruitment Analyst Information: If you have any questions regarding this… more