- Premier Administrative Solutions (Clearwater, FL)
- …client trust. *Investigates and participates in formal responses relating to complaints, grievances and appeals received by or applicable to PAS. Participates ... Overview Claims Manager Servicing Health Insurance Policies or Benefits Summary:...as transparency in reporting results, trends and issues to Senior Management and clients. *Management of relationships with Preferred… more
- Veracity Solutions (Kennewick, WA)
- …problems, such as: working conditions, disciplinary actions, and employee and applicant appeals and grievances , according to circumstances, and provides guidance ... and executes best practices for hiring and talent management. *Collaborates with senior leadership to understand the organization's goals and strategy related to… more
- CAPPS (Austin, TX)
- …and free meals while on duty. GENERAL DESCRIPTION Performs advanced ( senior -level) nutrition services work assisting the agency's Nutrition Services Manager ... trends relating to the nutrition and food services program; investigates youth grievances , as needed; and develops and assists with developing responses to grievance… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Accounting/Finance Department: CSC Appeals & Grievances ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist...Specialist II is responsible for assisting the Appeal and Grievances Compliance, Training and QA Manager to… more
- Elevance Health (Columbus, GA)
- **Grievance/ Appeals Analyst Senior ** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... skill development. Shift hours: 8:00am - 4:30pm EST** The **Grievance/ Appeals Analyst Senior ** is responsible for reviewing,...analyzing, and processing complex pre service and post service grievances and appeals requests in the Enterprise… more
- Sharp HealthCare (San Diego, CA)
- …as needed.Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight...needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'… more
- CHS (Clearwater, FL)
- …client trust. * Investigates and participates in formal responses relating to complaints, grievances and appeals received by or applicable to PAS. Participates ... **Overview** **Claims Manager ** **Servicing** **Health Insurance Policies or Benefits** **Summary:**...as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with… more
- Sacramento County (Sacramento, CA)
- Human Services Division Manager Range A/B Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2234944) Apply Human Services Division Manager ... $12,042.50 - $14,636.88/month Under executive direction, the Human Services Division Manager plans, coordinates and administers a human services division comprised… more
- Guardian Life (Bethlehem, PA)
- …contact for all assigned DSOs. Respond to provider inquiries, concerns, complaints, appeals and grievances within assigned timeframes. Collaborate across teams ... Organization (DSO) partners. As a **Key DSO Dental Account Manager , Dental Support Organizations** , you will be responsible...financial reimbursement rates with DSOs + Make presentations to senior -level management of DSOs + Identify and report to… more
- Sharp HealthCare (San Diego, CA)
- …+ Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief...the ability to interface effectively with employees, members, physicians, senior management, and the public at large. + Management… more
- Somatus (Mclean, VA)
- …Special Need Plans (SNPs). The Director, Quality will work closely with Sr. Manager , Audit Risk and the Regulatory and Accreditation Team to ensure compliance with ... audits, complaints/ grievances , and adherence to contractual obligations and Service Level...pre-delegation audits, annual client audits, development of grievance and appeals workflow processes, and other regulatory requirements. + Direct,… more
