- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist...to computer learning. Time management and priority setting skills. Must be organized and a team player Able to… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist ...of Medical terminology and strong advocacy experience. Skills Required: Must be organized, detail oriented, able to exercise strong… more
- Insight Global (Los Angeles, CA)
- Job Description The Customer Solution Center Appeals and Grievances Specialist I will support the Appeals and Grievances team to receive, investigate ... of this role is to learn the specialty level appeals and grievances work by resolving less...able to interpret and apply regulations. -Strong advocacy experience. - Must be organized, detail oriented, able to exercise strong… more
- Generac Power Systems (Waukesha, WI)
- …into an energy technology solutions company, we continue to push new boundaries. The ** Appeals and Grievances Specialist ** is a critical team player who ... general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** Case...stoop, bend or reach above the shoulders. The employee must occasionally lift up to 25 - 50 pounds.… more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... purpose. Job Summary The Lead of Customer Solution Center Appeals and Grievances is responsible for assisting...satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** Appeals and Grievances Representative supports the Operations Department and the Appeals and Grievances team in a ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with...0-2 years. - Associate's Degree or equivalent experience. - Must be a self-starter with a high degree of… more
- Sutter Health (Modesto, CA)
- **Organization:** MMC-Memorial Medical Center **Position Overview:** The Grievances & Appeals Specialist supports the patient and family experience through ... and other feedback received by the organizations. Complaints and grievances include, but are not limited to, the care...of complexity and require a great deal of innovation. Must collaborate closely with managers, physicians and staff throughout… more
- CareOregon (Portland, OR)
- …customer service, claims processing, prior authorizations, formulary exceptions, appeals , grievances , and project participation. Essential Responsibilities ... Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona,...decisions. + Perform prior authorization reviews with pharmacist oversight. Appeals and Grievances + Explain pharmacy appeal… more
- LA Care Health Plan (Los Angeles, CA)
- …by working closely with translation vendors during the high-volume periods. The C&L Specialist II investigates and analyzes member grievances related to C&L ... Cultural and Linguistic Services Specialist II Job Category: Clinical Department: Cultural &...C&L grievance and complaint process by working closely with Appeals and Grievances (A&G) and language vendors… more
- Indian Health Service (Shiprock, NM)
- …functions: (a) adverse and disciplinary actions, (b) both administrative and union grievances and appeals , (c) employee benefits including retirement, and (d) ... AZ; 1 for Shiprock, NM. The incumbent serves as a Human Resources Specialist in the field of Employee Relations and Labor Relations which specifically includes… more
- State of Colorado (CO)
- CDOC - Human Resources Specialist V (Human Resources Manager) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4652787) Apply CDOC - Human ... Resources Specialist V (Human Resources Manager) Salary $7,460.00 - $11,938.00...develops performance plans and signs performance documents; resolves informal grievances ; provides coaching, mentoring, approves leave, manages workloads; +… more
- Maryland Department of Transportation (Baltimore City County, MD)
- …and local Employment laws, advising and representing management on employee disciplinary appeals and grievances , as well as experience interacting with ... Labor Relations Specialist (Administrator III) Salary $69,323.00 - $112,044.00 Annually...of experience advising and representing management on employee disciplinary appeals and grievances , as well as experience… more
- State of Colorado (CO)
- CDOC - Human Resources Specialist IV (Employee Relations Work Lead) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4650990) Apply CDOC - ... Human Resources Specialist IV (Employee Relations Work Lead) Salary $5,845.00 -...staff on active discrimination/ harassment investigations, grievance panels, ADA, appeals , and other concerns; + Represent the unit to… more
- State of Colorado (CO)
- CDOC Human Resource Specialist III (Labor Relations Consultant) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4660099) Apply CDOC Human ... Resource Specialist III (Labor Relations Consultant) Salary $4,809.00 - $7,695.00...but not limited to corrective and disciplinary matters and grievances ; + Conduct initial interviews and gathers information for… more
- Department of State - Agency Wide (Washington, DC)
- …Protection Board (MSPB) Acknowledgment Orders; serves as technical representative on MSPB appeals and Foreign Service Grievance Board (FSGB) grievances . Provides ... and suitability program to include policy development, discipline, adverse actions, appeals , standards of conduct, performance based actions, mediation of potential … more
- Veterans Benefits Administration (Newark, NJ)
- …relations issues. Advise on actions concerning employee management communications, grievances and appeals , disciplinary actions and performance. Research ... requirements as noted below. To qualify for this Program Specialist , GS-0301-09 position: Applicants must have one...for this Program Specialist , GS-0301-09 position: Applicants must have one year of specialized experience that is… more
- LA Care Health Plan (Los Angeles, CA)
- …experience in a patient care setting and/or combination in utilization management, appeals and grievances , delegation oversight, and/or CNA experience. At least ... Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization...and commercial lines of business. Skills Required: Technical skills: Must be computer literate, with expertise in Outlook, Word,… more
- US Army Civilian Human Resources Agency (IN)
- …Wisconsin. Responsibilities Serve as a senior Human Resources (HR) Specialist performing operational assignments involving Employee Relations and Labor Relations. ... Veterans Employment Opportunity Act (VEOA) of 1998 In order to qualify, you must meet the experience requirements described below. Experience refers to paid and… more
- Nuclear Regulatory Commission (Naperville, IL)
- …employee-management relations in carrying out HR operations to include responding to grievances , appeals , and other information requests. Participates in labor ... will perform the full range of Senior Human Resources Specialist duties. Such duties include but are not limited...to a clearance is required for new hires. You must meet the qualifications for this position by no… more
- City of New York (New York, NY)
- …of Correction ("DOC" or "the Department"); - Investigate serious incidents; - Review grievances from people in custody and staff; - Evaluate the performance of DOC; ... a period of growth and change. JOB DESCRIPTION The Board seeks a Standards Specialist ("Monitor") with a passion for justice, fairness, and human rights, and the… more