- 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
- Elevance Health (San Antonio, TX)
- …and personalized support throughout the consumer's treatment journey. **Title:** Grievance / Appeals Representative II **Location:** TX-SAN ANTONIO, 4751 HAMILTON ... immediate support **Build the Possibilities. Make an extraordinary impact.** The Grievance / Appeals Representative II is responsible for reviewing, analyzing and… more
- Intermountain Health (West Valley City, UT)
- **Job Description:** The RCO Appeals Hearing Specialist is responsible for investigating, coordinating and managing legal insurance cases and represents ... and works closely with Intermountain Health legal team, Physician Advisors, and Appeals RN consultants in their various capacities. Fully remote position! +… more
- Molina Healthcare (Phoenix, AZ)
- …+ 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
- Tufts Medicine (Boston, MA)
- …involving a variety of areas including employee discipline/corrective action and employee appeals and the grievance process. 2. Develops and modifies Employee ... union contract administration including the investigation of grievances, drafting grievance responses, MOA preparation. 6. Coordinates and prepares information for… 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
- Sutter Health (Sacramento, CA)
- …**Organization:** SMF-Sutter Med Foundation- Central **Position Overview:** The Grievances & Appeals Specialist RN supports the patient and family experience ... CMS requirements and standards such as performance improvement, patient safety, and grievance management. Local, State and Federal laws / regulations pertaining to… more
- City and County of San Francisco (San Francisco, CA)
- …discrimination complaints filed by Airport guests in accordance with federal grievance procedures; serves as a community liaison; evaluates and inspects facilities ... a related field. + Possession of a Certified Access Specialist (CASp) certification in good standing with the California...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… 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
- 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