- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances ... No **Essential Duties & Responsibilities** Processing of Grievances & Appeals : + Responsible for the progress of grievance... Appeals : + Responsible for the progress of grievance and appeal intervention and resolution. + Assure verbal… more
- Molina Healthcare (New Haven, CT)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance … more
- Commonwealth Care Alliance (Boston, MA)
- …& Responsibilities:** + Conduct monthly case review of a random sample of appeals and grievance cases against previously developed scorecard and Federal and ... 011540 CCA- Appeals & Grievances **Position Summary:** Appeals ...+ Communicate and work collaboratively with AG Representatives, Resolution Specialist and Management to maintain and improve quality of… more
- State of Colorado (Denver, CO)
- …are maintained + shared responsibility for this process to address the client's grievance as the Compliance Specialist + addresses all referred grievances that ... Health Professional III- MHTL Compliance Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4932074) Apply Health Professional III-… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- Title: Labor/Employee Relations Specialist I/ II/ III (Non-competitive Progression) Location: United States-Virginia-Virginia Beach Job Number: 250000Q1 Note: This ... Summary: Under the guidance and supervision of a Labor/Employee Relations Specialist or Labor/Employee Relations Manager, responsible for providing technical support… more
- Trinity Health (Mishawaka, IN)
- …action plans, and monitor infection control + Support the Quality Committee and grievance / appeals processes + Assist in emergency preparedness and policy updates ... Full time **Shift:** **Description:** **Job Posting: Quality and Compliance Specialist ** **Ministry: Trinity Health PACE** **Position Purpose** Join our… more
- Transportation Security Administration (Queens, NY)
- …technical aspects of the work directed (employee relations principles and practices, appeals and grievance processes, OWCP, position management, staffing, human ... of movement for people and commerce. Responsibilities This Supervisory Human Resources Specialist position is located at John F. Kennedy International Airport (JFK),… more
- State of Colorado (Chaffee County, CO)
- …responding to offender disciplinary appeals , answering offender classification appeals , review of offender grievance responses, and gathering information ... of the department's action. For more information about the appeals process, the official appeal form, and how to...position, please direct your inquiries to our Employee Relations Specialist , Kristen Lange , at doc_###@state.co.us or call ###… more
- Johns Hopkins University (Baltimore, MD)
- …actions and make sound recommendations to management. + Manage the grievance process, including fact finding, reviewing evidence, serving as hearing officer, ... as an advisor to employees and management on employee appeal and grievance issues. + Work in partnership with department management regarding appropriate… more
- Missouri State University (Springfield, MO)
- Posting Details Position Information Position Title Administrative Specialist II, College of Education Administration Work Location Springfield Campus Department COE ... Type Full Time Regular Exempt/Non-Exempt Non-Exempt General Function The Administrative Specialist II works in depth with programs, processes, or services that… more
- State of Colorado (Pueblo, CO)
- …referrals and consultations, medical reporting, medical co-signature and inmate grievance requirements are completed in accordance with DOC Administrative ... of the department's action. For more information about the appeals process, the official appeal form, and how to...position, please direct your inquiries to our Employee Relations Specialist , Kristen Lange , at doc_###@state.co.us or call ###… more
- Elevance Health (Cerritos, CA)
- …necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures ... a health profession. **Preferred skills, capabilities, and experiences:** + Oncology specialist preferred + Internal medicine specialist preferred For candidates… more