- Dignity Health (Rancho Cordova, CA)
- …This position is hybrid in-office and work from home.** **Position Summary:** The Appeals and Grievances Coordinator is responsible for supporting the ... regulatory requirements - facilitating timely and effective resolution of appeals and grievances . Acting a subject matter...grievances . Acting a subject matter expert (SME), the Coordinator will work closely with internal teams and external… more
- CVS Health (Springfield, IL)
- …+ Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs to ... Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs… more
- CVS Health (Baton Rouge, LA)
- …Summary Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs ... Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs… more
- CoreCivic (Mason, TN)
- …a responsibility to better the public good. We are currently seeking a **Grievance Coordinator ** who has a passion for providing the highest quality care in an ... making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures that both informal and… more
- Cedars-Sinai (Beverly Hills, CA)
- …the payor + Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate ... About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient...the Inpatient Specialty Program (ISP) hospitalists, the RN Care Coordinator will assist patients from the time they are… more
- Elevance Health (Port St. Lucie, FL)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Bilingual in Spanish/English)** **Schedule:** Monday-Friday 8am-5pm **Location**...is granted as required by law._ The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
- Elevance Health (Chillicothe, OH)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Case Manager)** **Hiring near Cambridge, Colerain, Chillicothe,...services and supports, and psychosocial needs. The **LTSS Service Coordinator ** is responsible for managing service coordination for a… more
- Highmark Health (Nashville, TN)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical ... staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification… more
- State of Colorado (Golden, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- …professional development training (as available). Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, ... interventions for all youth. Responds to and resolves youth grievances . Act as first public contact with agency when...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- City of New York (New York, NY)
- …and administer the contractual grievance process. Serve as Hearing Officer for grievances and disciplinary appeals . Represent the agency at hearings before ... play a key role in managing internal labor relations investigations, union grievances , and collective bargaining agreements and engagement with Union Partners, and… more
- The County of Los Angeles (Los Angeles, CA)
- …personnel in their unit and effectively recommending the adjustment of grievances and disciplinary problems. Other positions are assigned such functions as: ... first level technical and administrative supervision to the complaint or advanced-level appeals unit. Essential Job Functions + Supervises the activities of all… more
- State of Colorado (Golden, CO)
- …hygiene practice. Ensure that youth are provided confidential access to grievances , medical assistance and mental health assistance as needed/requested without staff ... of the department's action. For more information about the appeals process, the official appeal form, and how to...this position, please direct your inquiries to our ADAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more
- State of Colorado (Jefferson County, CO)
- …and interdisciplinary coordination. This position is the primary infection prevention coordinator and trainer for the facility and is responsible for reporting ... of two methods. + Addresses individual/family/guardian complaints and resolves grievances at the lowest level. + Provide nursing care...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
- TEKsystems (Honolulu, HI)
- …Conducts critical analysis of highly complex and sensitive member and provider appeals , inquiries and grievances and applies internal policies and procedures, ... position and concerns to management and decision makers. Assists Supervisor and Coordinator in working as a liaison with providers, members and internal decision… more
- State of Colorado (Denver, CO)
- …conflicts, investigates and problem solves internal and external complaints and grievances from staff, youth, family, and other customers. Scheduling of clinic ... of the department's action. For more information about the appeals process, the official appeal form, and how to...this position, please direct your inquiries to our ADAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more
- Community Legal Services, Inc. (Philadelphia, PA)
- …researching relevant rules, and applying them to cases + Filing administrative appeals and engaging in administrative advocacy under the supervision of an attorney ... + Representing clients (with attorneys) at administrative hearings or informal grievances with Medicaid Managed Care Organizations as needed + Presenting community… more
- University of Miami (Coral Gables, FL)
- …Retired Faculty. + Assists the Vice Provost in managing salary review and appeals . + Reviews and process Coral Gables and Rosenstiel Schools requests for courtesy ... University sponsorship. Employee Relations: + Serves as the Deputy Title IX Coordinator for faculty. Responsible for reviewing Title IX complaints and allegations… more