- AmeriHealth Caritas (Philadelphia, PA)
- …more about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances , this position is responsible for the ... complaints/issues to management + Monitors to ensure that all problems with appeals / grievances presented by plan members/participants are resolved in accordance… more
- Dignity Health (Rancho Cordova, CA)
- …This position is hybrid in-office and work from home.** **Position Summary:** The Appeals and Grievances Coordinator is responsible for supporting the ... regulatory requirements - facilitating timely and effective resolution of appeals and grievances . Acting a subject matter...grievances . Acting a subject matter expert (SME), the Coordinator will work closely with internal teams and external… more
- Insight Global (Irvine, CA)
- Job Description An employer is looking for a remote Appeals & Grievances Coordinator that will be responsible for managing and resolving appeals and ... teams and external stakeholders. Key Responsibilities - Review, research, and process appeals and grievances in compliance with company policies and regulatory… more
- Centene Corporation (Indianapolis, IN)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and appeals + Maintain files on… more
- UPMC (Pittsburgh, PA)
- …in the greater Pittsburgh area. This position will track, trend, and manage member grievances , appeals , and IRE requests for the Medicare and SNP product lines. ... UPMC Health Plan is hiring a full-time Member C&G Coordinator I, Medicare/SNP. This position works Monday through Friday,...will ensure the efficient and effective resolution of member grievances , appeals , and IRE requests according to… more
- CoreCivic (Mason, TN)
- …a responsibility to better the public good. We are currently seeking a **Grievance Coordinator ** who has a passion for providing the highest quality care in an ... making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures that both informal and… more
- State of Colorado (Jefferson County, CO)
- HEALTH CARE TECHNICIAN IV - Residential Coordinator for Secrest House Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5146487) Apply HEALTH ... CARE TECHNICIAN IV - Residential Coordinator for Secrest House Salary $50,724.00 - $71,016.00 Annually...reviews (PMPs). + Determines and responds to Step 1 grievances if staff supervised initiates a formal grievance. +… more
- Cedars-Sinai (Beverly Hills, CA)
- …the payor + Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate ... About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient...the Inpatient Specialty Program (ISP) hospitalists, the RN Care Coordinator will assist patients from the time they are… more
- Elevance Health (Steubenville, OH)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Case Manager)** **Hiring near Cadiz, Coshocton, Gallipolis,...services and supports, and psychosocial needs. The **LTSS Service Coordinator ** is responsible for managing service coordination for a… more
- Elevance Health (Fort Lauderdale, FL)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator ** **Location** _:_ This is primarily a field...law._ **Schedule** _:_ Monday-Friday 8am-5pm EST The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
- Elevance Health (Neillsville, WI)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Case Manager)** **Hiring near Southwestern Wisconsin in...employment, and contributing to their communities. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
- Highmark Health (Nashville, TN)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical ... staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification… more
- State of Colorado (Golden, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- …professional development training (as available). Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, ... interventions for all youth. Responds to and resolves youth grievances . Act as first public contact with agency when...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- City of New York (New York, NY)
- …and administer the contractual grievance process. Serve as Hearing Officer for grievances and disciplinary appeals . Represent the agency at hearings before ... play a key role in managing internal labor relations investigations, union grievances , and collective bargaining agreements and engagement with Union Partners, and… more
- Colorado State University (Fort Collins, CO)
- …faculty and staff recruitment, regulatory compliance, faculty and staff grievances , consulting and conflict of interest. + Manage Departmental communications, ... signature authority for State Classified staff. + Serve as Work-Study Coordinator , Departmental Designee for Worker's Compensation, Key Manager, and Departmental… more
- The County of Los Angeles (Los Angeles, CA)
- …personnel in their unit and effectively recommending the adjustment of grievances and disciplinary problems. Other positions are assigned such functions as: ... first level technical and administrative supervision to the complaint or advanced-level appeals unit. Essential Job Functions + Supervises the activities of all… more
- Iowa Department of Administrative Services (Newton, IA)
- …Benefits + Questions Job Description This position: Will investigate incarcerated individual's grievances and process ICON for NCF and CRC. . Analyzes complaints and ... that have been presented through the grievance process. Ensures grievances are received, processed, investigated and answered timely. Completes responsibilities… more
- State of Colorado (Denver, CO)
- …conflicts, investigates and problem solves internal and external complaints and grievances from staff, youth, family, and other customers. Scheduling of clinic ... of the department's action. For more information about the appeals process, the official appeal form, and how to...this position, please direct your inquiries to our ADAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more
- State of Colorado (Denver, CO)
- …Resolve employee performance problems and issues, disputes, and informal (Step 1) grievances ; issue corrective actions and initiate discipline as needed. + Write and ... and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules . Supplemental Information A… more