- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
- Insight Global (Los Angeles, CA)
- …by management: Write determination letters regarding the outcome of non- clinical reviews/claim denials and send to the applicable participant/provider. Correspond ... by the examiners or Participant Services Representatives when necessary. Assist Appeals Coordinator with preparation of Benefits Committee appeal cases. Develop… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Care Management Coordinator Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... net required to achieve that purpose. Job Summary The Supervisor of Care Management Coordinator is responsible for direct...in Managed Care preferably in Customer Service, Care Management, Appeals and Grievances and/or Claims. Participated in… more
- LA Care Health Plan (Los Angeles, CA)
- …closely with the Chief Operating Officer (COO) to allow for integration with claims, appeals and grievances , and our customer service center. The COE ensures ... Clinical Operations Executive Job Category: Management/Executive Department: Utilization...all HIPAA requirements. Actively identifies and makes recommendations to supervisor , ideas to improve the quality effectiveness and efficiency… more