• Grievances and Appeals 3

    CenterWell (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by ... trained skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced… more
    CenterWell (10/08/25)
    - Save Job - Related Jobs - Block Source
  • Manager II Grievance & Appeals

    Elevance Health (Norfolk, VA)
    …an accommodation is granted as required by law._ The **Manager II Grievance & Appeals ** responsible for management oversight of grievances and appeals ... departmental units to investigate, resolve, and respond to grievances and appeals , manages inventory and production...degree and a minimum of 5+ years grievance & appeals experience and a minimum of 3 more
    Elevance Health (10/02/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Clinical Appeals

    Cognizant (Richmond, VA)
    …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
    Cognizant (10/09/25)
    - Save Job - Related Jobs - Block Source
  • Director, Quality

    Somatus (Mclean, VA)
    …the Regulatory and Accreditation Team to ensure compliance with audits, complaints/ grievances , and adherence to contractual obligations and Service Level Agreements ... client pre-delegation audits, annual client audits, development of grievance and appeals workflow processes, and other regulatory requirements. + Direct, implement,… more
    Somatus (08/12/25)
    - Save Job - Related Jobs - Block Source
  • Remote Director of Health Plan Business Testing

    Insight Global (Norfolk, VA)
    …include Claims, Encounters, Benefits Configuration, Claims & Pricing Configuration, Enrollment, Appeals & Grievances , and Contact Center/Customer Service. * ... a global third-party vendor contract specific to testing * 3 years with QNXT or FACETS **CANDIDATES MUST RESIDE...BELOW STATES TO WORK REMOTELY** 1. Alabama 2. Delaware 3 . Florida 4. Georgia 5. Idaho 6. Indiana 7.… more
    Insight Global (09/09/25)
    - Save Job - Related Jobs - Block Source
  • Lead Contract Specialist

    United States Fleet Forces Command (Naval Base, VA)
    …will resolve simple, informal employee complaints and refers complex issues (eg, grievances , appeals ) to the appropriate management or HR officials. Requirements ... time of application: 1) agency notice; 2) most recent performance appraisal; and 3 ) most recent SF-50 or notification of personnel action that includes position,… more
    United States Fleet Forces Command (10/07/25)
    - Save Job - Related Jobs - Block Source