- Optum (San Juan, PR)
- …teams in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances . This position will communicate with appropriate ... implications and decisions. In addition, analyze and identifies trends for all appeals and grievances . Primary Responsibilities: Manage and resolve healthcare … more
- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, ... required to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and… more
- Point32Health (Watertown, MA)
- …responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for ... + Must be able to organize, plan and implement the functions of Member Appeals and Grievances , maintain timelines and turnaround times to meet multiple… more
- Independent Health (Buffalo, NY)
- …responsible for the collection and review of medical records specific to quality complaints/ grievances and appeals as indicated in support of a high performing ... plan and physician network. The Clinical Reviewer will investigate quality complaints/ grievances and appeals , document research of initial coverage… more
- Fallon Health (Worcester, MA)
- …NCQA standards, other applicable regulatory requirements and member expectations. The FH Member Appeals & Grievances Coordinator serves to administer the FH ... of Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Coordinator serves as a liaison between FH… more
- CVS Health (Carson City, NV)
- …claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals . + Initiates out-reach/welcome calls to ensure constituents ... heart, each and every day. **Position Summary:** Health Concierge -Customer Service Representative is the face of Aetna to provide targeted, personalized service… more
- Independent Health (Buffalo, NY)
- …of appeals /complaints. + Ensure verbal and written responses to complaints/ grievances , appeals and investigations follow regulatory standards. + Provide ... priority. + Monitor daily reports to ensure accuracy and timeliness of complaints/ grievances and appeals . + Assist in continuously developing systems, workflows,… more
- State of Colorado (Sterling, CO)
- …plans, and conducts performance evaluations; resolves informal staff and/or inmate grievances . Assigns tasks, monitors and inspects work progress and ensures ... pay, creates schedule and assigns tasks and resolves informal grievances according to agency policy; reduces inmate idleness and...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (CO)
- …actions; develop performance plans and sign performance documents; resolve informal grievances ; provide coaching, mentoring, approve leave, manage workloads; + Serve ... that ensure efficiencies and/or streamlining processes; + Serve as lead representative on statewide initiatives by developing and maintaining relationships with… 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...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Colorado Springs, CO)
- …Individualized Program Instruction/Tutoring, Multi-Disciplinary Staffing, Responding to Offender Grievances and Resolving Offender Issues, Offender Housing Placement ... hearings, ICC, Multi disciplinary staffing, vetting responses to offender grievances etc. Therefore, experience as an entry level officer...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Brighton, 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...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- City and County of San Francisco (San Francisco, CA)
- …Duties: According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job code/class and are ... boards and commissions and in meetings with other departments. 7. Responds to appeals or protests of human resources decisions and/or procedures; and prepares and… more
- Transdev (Readville, MA)
- …of internal policies and procedures and regulations for accurate resolution of appeals , complaints, and grievances . + Understand legal requirements and ... + Manage the grievance process and provide comprehensive responses to complaints, grievances , and arbitrations that support the Company's decision and comply with… more
- State of Colorado (Pueblo, CO)
- …Director. You will find the appeals process, theofficial appeal form ... submitted on the official appeal form (Adobe PDF), signed by you or your representative . This form must be delivered to the State Personnel Board by email… more
- City of Stockton, CA (Stockton, CA)
- …in labor negotiations; provides strategic guidance to staff on disciplinary appeals , grievance/arbitration appeals and labor negotiations proposals. + ... complex employee relations issues including proposed disciplinary actions, sensitive grievances , and contract interpretation. + Administers, audits, prepares, and… more
- State of Colorado (Denver, CO)
- …plans, corrective and disciplinary actions, assist resolving informal grievances , staff scheduling, position descriptions, recruitment, retention, interviewing and ... the official appeal form, signed by you or your representative . This form must be delivered to the State...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)
- …conflicts, investigates and problem solves internal and external complaints and grievances from staff, youth, family, and other customers. Scheduling of clinic ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Greeley, CO)
- …+ Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, follow up and appropriate action Shift Supervision + ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Limon, CO)
- …and ensuring the completion of annual training. + Resolve conflict and informal grievances at the lowest level possible + Ensure safe, efficient, compliant and cost ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
