- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... support the safety net required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... that purpose. Job Summary The Supervisor , Customer Solution Center Appeals & Grievances is responsible for direct supervision and support of the team… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will...Monitors closure of complaints and works with Quality Control Supervisor to resolve all database issues. Prepare and analyze… more
- Humana (Columbus, OH)
- …Master's degree in Business, Finance, Healthcare or related field + 3 years of Grievances and Appeals experience. + Working experience with Power BI and/or ... help us put health first** The Manager, Grievance and Appeals ensures that products meet certain standards of quality....Senior Leadership + 2 or more years of leadership ( Supervisor , Manager or above) experience + Strong knowledge of… more
- State of Colorado (Golden, CO)
- Correctional Youth Security Supervisor III - Summit Main Swing Shift in Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4452562) Apply ... Correctional Youth Security Supervisor III - Summit Main Swing Shift in Golden Salary $32.52 - $33.50 Hourly Location Golden, CO Job Type Full Time Job Number IKA… more
- State of Colorado (Denver, CO)
- ECMC Enforcement Supervisor Compliance Specialist V - Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4544395) Apply ECMC Enforcement ... Supervisor Compliance Specialist V - Hybrid Salary $86,916.00 -...coaching/feedback and appraisals, recommends corrective/disciplinary action, and resolves informal grievances . Ensuring regulatory compliance: + Coordinate with the Enforcement… more
- State of Colorado (Pueblo, CO)
- Occupational Therapist Supervisor - Therapist IV Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4506134) Apply Occupational Therapist ... Supervisor - Therapist IV Salary $98,000.00 Annually Location Pueblo,...signs performance plans, reviews and evaluations and resolves informal grievances . Position starts the hiring process, interviews applicants, and… more
- Spokane County (Spokane, WA)
- …as needed. + Oversees administrative management of the Grievance System, to include grievances , appeals and fair hearings. Identifies trends in Grievance System ... Integrated Behavioral Healthcare Quality Supervisor Print (https://www.governmentjobs.com/careers/spokanecountywa/jobs/newprint/4536359) Apply Integrated Behavioral Healthcare… more
- Sacramento County (Sacramento, CA)
- Liability and Property Insurance Supervisor Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/4458114) Apply Liability and Property Insurance ... Supervisor Salary $105,026.40 - $127,660.32 Annually Location Sacramento, CA...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Hackensack Meridian Health (Hackensack, NJ)
- …functions and performance improvement activities for the case managers. The Supervisor Case Management is accountable for the department's designated staff caseload ... case management process, including LOS, throughput, patient flow and denials and appeals follow up. i. Responsible for staff productivity and ongoing education. j.… more
- CVS Health (Columbus, OH)
- …but not limited to customer service, claim, provider services, complaints, grievances , and appeals , implementation, and/or plan sponsor operations. Executes ... industry-leading solutions for our customers and members. The A1A Customer Service Supervisor will maintain oversight of functions in local service center, including… more
- The Cigna Group (Nashville, TN)
- …related issues, implications and decisions. The Case Management Analyst reports to the Supervisor /Manager of Appeals and will coordinate and perform all appeal ... in Medicare Part C + Ability to differentiate different types of requests Appeals , Grievances , coverage determination and Organization Determinations in order to… more
- CVS Health (Austin, TX)
- …but not limited to: customer service, claim, provider services, complaints, grievances , and appeals , implementation, and/or plan sponsor operations. Responsible ... for the quality, efficiency and effectiveness of own team, identifying and resolving routine problems. Sets priorities for and coaches employees to meet goals. Additional responsibilities to include: + Develops, motivates, evaluates and coaches staff on work… more
- Commonwealth Care Alliance (Worcester, MA)
- …coordinate with relevant department(s) within CCA, or contracted IPAs + Assist members with appeals and grievances status, coordinate with Appeals and ... huddles and team meetings (as required)Additional duties as requested by supervisor **Working Conditions:** Standard office conditions. Eligible to hybrid remote… more
- State of Colorado (Denver, CO)
- …youth, in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional or ... + Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, follow up and appropriate action Shift Supervision +… more
- State of Colorado (Trinidad, CO)
- …at this location. Description of Job This Correctional Support Licensed Trades Supervisor II (CSLTS II) is a Journeyman Electrician at the Trinidad Correctional ... completion of annual training; + Resolve conflict and informal grievances at the lowest level possible; + Ensure safe,...duties of other crews in the absence of another supervisor and/or assisting other trades/crews on additional projects; working… more
- State of Colorado (Denver, CO)
- …youth, in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional, or ... as required. Ensure that youth are provided confidential access to grievances , medical and behavioral health services as needed/requested. Distribute youth… more
- State of Colorado (Sterling, CO)
- …at this location. Description of Job This Correctional Support Licensed Trades Supervisor I is a Boiler Operator with Stationary Engineer Certification at the ... inmate hours and pay, creates schedule and assigns tasks and resolves informal grievances according to agency policy; reduces inmate idleness and creates real life… more
- Gwinnett County Public Schools (Suwanee, GA)
- …of Employee Relations will assist in providing resolution in matters related to grievances and appeals , training and development to administrators and employees ... on equity, compliance, accommodation, grievances , and Title IX.1. Leads equal opportunity and other legal related complaint processes including intake, case… more
- State of Colorado (Canon City, CO)
- …to report to the listed address 4 days a week at the discretion of the supervisor and based on business need, and after the initial training period. This position is ... of the information; + Respond to offender inquiries and grievances ; + Produce reports for electronic distributions, listing all...of the department's action. For more information about the appeals process, the official appeal form, and how to… more