- Point32Health (MA)
- …partners, colleagues and communities. **Job Summary** Under the general direction of the Manager, Appeals and Grievances the Supervisor , Appeals and ... will coordinate and provide leadership for the daily operations of the Appeals and Grievances department. The supervisor represents the Appeals and… more
- Point32Health (Watertown, MA)
- …colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA...Federal and State Regulations. Complete individual summary scorecards for Supervisor feedback. + Track monthly scores on spreadsheet and… more
- Fallon Health (Worcester, MA)
- …NCQA standards, other applicable regulatory requirements and member expectations. The FH Member Appeals & Grievances Coordinator serves to administer the FH ... departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Coordinator serves as a...rotational in-office calendar or at the direction of a supervisor or manager. Answers telephone calls via ACD queue,… more
- Beth Israel Lahey Health (Westwood, MA)
- …address information. Escalates calls to pharmacists for clinical inquiries and escalates grievances to supervisor . 7. Maintains new and existing patient profiles ... Support health care providers with required prior authorization and required appeals . Manage all mail/delivery of Rx orders including addressing problems/issues with… more