- Evolent (Albany, NY)
- …or GED is required. + Minimum of 3 years' experience in an Appeals and Grievances role or comparable administrative role within a health plan, managed ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Appeals and Grievances ** at Evolent is responsible for reviewing and processing case requests,… more
- Evolent (Albany, NY)
- …**Required** + Minimum of 5 years in Utilization Management, health care Appeals , compliance and/or grievances /complaints in a quality improvement environment- ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...to 7pm CST (which includes 30-minute unpaid lunch break) 3 days/week, to meet the business needs of nurses… more
- Cognizant (Albany, NY)
- …or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances , precertification, initial and concurrent reviews . ... . Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes.… more
- CUNY (Brooklyn, NY)
- …Rules); tracking student conduct reports; coordinating the student conduct process, grievances , and appeals . + Oversee the Faculty Student Disciplinary ... process, early intervention student support service process, the resolution of student grievances , appeals , and complaints, and the utilization of the Behavioral… more
- City of New York (New York, NY)
- …United States law school as defined in the Rules of the New York Court of Appeals (Sections 520. 3 or 520.5) or admission to the New York State Bar. Additional ... related to labor law and employee discipline. The unit handles employee grievances , prosecutes disciplinary cases, and works with attorneys at the Mayor's Office… more
- City of New York (New York, NY)
- …issues including license and access issues, leasing, and eminent domain 3 ) procurement related issues including responsive and responsibility issues, bid protests, ... the Uniform Commercial Code ("UCC"); 10) assist division staff with procurement appeals and decision process, including draft opinions and presenting facts and… more
- MTA (New York, NY)
- …and participate in monthly conferences with union representatives to discuss contract grievances and employee discipline appeals ; perform analytical review of ... Authority is North America's largest transportation network, serving a population of 15. 3 million people across a 5,000-square-mile travel area surrounding New York… more
- City of New York (New York, NY)
- …United States law school as defined in the Rules of the New York Court of Appeals (Sections 520. 3 or 520.5) or admission to the New York State Bar. Additional ... for matters pending with the NYC Law Department and the NYC Comptroller's Office; 3 ) review agency responses to the public pursuant to the Freedom of Information Law… more
- Molina Healthcare (Syracuse, NY)
- …reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more
- City of New York (New York, NY)
- …advice on a wide range of topics related to every aspect of DDC's program needs. 3 ) Support the DDC Law by conducting legal research on a wide range of topics. 4) ... the Uniform Commercial Code ("UCC"). 10) Assist division staff with procurement appeals and decision process, including draft opinions and presenting facts and… more
- City of New York (New York, NY)
- …issues including license and access issues, leasing, and eminent domain 3 ) Procurement related issues including responsive and responsibility issues, bid protests, ... the Uniform Commercial Code ("UCC") 10) Assist division staff with procurement appeals and decision process, including draft opinion and presenting facts and… more
- City of New York (New York, NY)
- …cases pending with the agency, the NYC Law Department and the NYC Comptroller's Office; 3 ) the review of agency responses to the public pursuant to the Freedom of ... Contracting Officer (ACCO) and agency procurement staff in relation to procurement appeals and decision process, including draft opinions and the presentation of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …multiple areas, including but not limited to UM and CM, Fair Hearings and Appeals / Grievances , within three months of working in position. + Demonstrates ability ... standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three ( 3 ) or more hours at a time. + Ability to work in a home office for… more
- City of New York (New York, NY)
- …of Correction ("DOC" or "the Department"); - Investigate serious incidents; - Review grievances from people in custody and staff; - Evaluate the performance of DOC; ... - Assisting in processing, evaluating and preparing responses to appeals from people in custody concerning the Minimum Standards...full-time paid experience as described in "1" above; or 3 . Education and/or experience equivalent to "1" or "2"… more