- Elevance Health (Indianapolis, IN)
- **Title: Grievances & Appeals Risk Analyst II** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within ... 50 miles of one of our PulsePoint locations. The ** Grievances & Appeals Risk Analyst II** will be responsible for providing support services for multiple… more
- Elevance Health (Cincinnati, OH)
- **Title: Grievances & Appeals Risk Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Grievances & Appeals Risk Analyst I** will be responsible for responding to inquiries received from… more
- Molina Healthcare (OH)
- …end users for operational and strategic analysis. This role supports our Appeals and Grievances team. **KNOWLEDGE/SKILLS/ABILITIES** + Performs research and ... analyses on a variety of topics related to the overall support of business operations. + Creates and maintains reports to manage claim inventory, adjustment processes, audits, compliance, recoveries, coordination with other departments. + Consolidates research… more
- Elevance Health (Cincinnati, OH)
- **Grievance/ Appeals Analyst I** **Location: Must be... analyst may serve as a liaison between grievances & appeals and /or medical management, ... flexible to work Monday-Friday or Tuesday-Saturday as needed** The **Grievance/ Appeals Analyst I** is an entry level...analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types… more
- Elevance Health (Cincinnati, OH)
- **Grievance/ Appeals Analyst Lead** **Must be located within 50 miles of a PulsePoint office** **This position is primarily work from home but requires working in ... a local office once per quarter** The **Grievance/ Appeals Analyst Lead** is responsible for leading...review, analyze and process pre service and post service grievances and appeals requests related to clinical… more
- Motion Recruitment Partners (Durham, NC)
- Appeals Analyst Durham, NC **100% Remote** Contract $15/hr - $19/hr Our client, a nationally recognized and award-winning company in the health insurance ... has a possible contract to hire opening for a Appeals Analyst . They have over 4 million...and investigate all aspects of the member and provider appeals and grievances , NCDOI, Congressional and/or Department… more
- ManpowerGroup (Durham, NC)
- **Title:** **Clinical Appeals Analyst ** **Location: 4613 University Drive Durham NC 27707 United States (Onsite)** **Duration: 6+ months** **Pay rate: $41.75/hr ... appeals as required. + Analyse complex/non-routine member and provider appeals and grievances for all lines of business, excluding FEP, by reviewing CMP,… more
- Motion Recruitment Partners (Durham, NC)
- Clinical Appeals Analyst Durham, NC **100% Remote** Contract $35/hr - $39/hr Our client, a nationally recognized and award-winning company in the health ... a possible contract to hire opening for a Clinical Appeals Analyst . They have over 4 million... as required. + Analyze complex/non-routine member and provider appeals and grievances for all lines of… more
- Elevance Health (Denison, TX)
- …of clinical information. + The analyst may serve as a liaison between grievances & and appeals and /or medical management, legal, and/or service operations, ... Department that reviews analyzes and processes non-complex pre-service and post-service grievances and appeals requests from customer types (ie member,… more
- City and County of San Francisco (San Francisco, CA)
- …bargaining agreements. + Key duties include negotiating resolutions to grievances , investigating complaints of serious employee misconduct, and conferring with ... professional human resources experience, similar to 1241 Human Resources Analyst , in one or more of the following areas...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …in plan types. It involves validating Annual & Biannual Reporting for both Appeals & Grievances and Enrollment teams, conducting Monthly and Quarterly Data ... audits, along with fulfilling other data requests. Additionally, this position aids in Appeals & Grievances and Enrollment processes by handling transactions and… more
- System One (Baltimore, MD)
- …knowledge of clinical operations, including Care Management, Utilization Management, and Appeals & Grievances . Previous experience using the GuidingCare, Care ... along with clinical operations, including Care Management, Utilization Management, and Appeals & Grievances . + Previous experience using the GuidingCare,… more
- Sacramento County (Sacramento, CA)
- …stakeholders to facilitate/lead projects or initiatives + Investigations and discipline + Grievances and appeals + Recruitment and selection + Classification and ... Principal Human Resources Analyst Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/4484028) Apply Principal Human Resources Analyst … more
- LA Care Health Plan (Los Angeles, CA)
- … Analyst III Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Business Analyst III facilitates business process improvement via the methodical investigation, analysis,… more
- LA Care Health Plan (Los Angeles, CA)
- …Grievance Compliance Advisor Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... call documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This… more
- State of Colorado (Denver, CO)
- …changes in pay; resolve problems, performance issues, disputes, and informal grievances ; initiate corrective action or recommend progressive discipline as needed; ... T1A3XXINFORMATION TECHNOLOGY SUPERVISOR (https://drive.google.com/file/d/0BwUD9Bt4G-21NENXR2tpR1RIdjg/view?resourcekey=0-ZYjfUz-FIJMBpDLeid-esw) MINIMUM REQUIREMENTS: A Human Resources Analyst will only review the work experience/job duties sections… more