- Harbor Health Services, Inc. (Mattapan, MA)
- …and consistency of decisions. Supervisory responsibilities for UM RN, Quality Analyst , Appeals and Grievances Specialist. Requirements: Bachelor's Degree ... additional Holidays and much more! Role: Reporting to the Senior Director of Health Plan Operations, the Director of...of quality measures and other data by the Quality Analyst for report to regulatory agencies, including CMS and… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... Collaborate with clinical staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed records in the… more
- Henry Ford Health System (Troy, MI)
- …for the prompt and thorough investigation of medical and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare Advantage, ... Medicare-Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis...from State and Federal agencies and speak before members, senior leaders and other key stakeholders to present appeal… more
- City and County of San Francisco (San Francisco, CA)
- …that the City and County of San Francisco has to offer. As a Senior Administrative Analyst , you will be responsible for directing and performing challenging, ... compliant contract operations. + Providing a real-world example, a Senior Contracts Analyst could assist with procurement...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …steps to advance in this selection process, which includes the following: Senior Human Resources Analyst Core Exam (Weight: 100%) Candidates self-certifying ... Qualifications will be invited to participate in the online Senior Human Resources Analyst Core Exam. Candidates...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …of California San Francisco and UC Law San Francisco. Under direction, the 1813 Senior Benefits Analyst performs complex benefits work for the City's health, ... projects in an assigned benefit program. Additionally, the 1813 Senior Benefits Analyst directly oversees a team...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- Clark County, NV (Las Vegas, NV)
- SENIOR ENTERPRISE SYSTEMS ANALYST Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4931637) Apply SENIOR ENTERPRISE SYSTEMS ... (ERP) is seeking qualified candidates to apply for the Senior Enterprise Systems Analyst position. We are...applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Healthcare Analyst Senior Location: Hybrid | Eagan, Minnesota Career Area: Data ... are ready to make a difference, join us. The Impact You Will Have The Senior Healthcare Analyst is responsible for contributing to and supporting the strategic… more
- Nightwing (Sterling, VA)
- …civil, and commercial markets. Nightwing seeks a full-time Information Review and Release Analyst ( senior -performance level) in the Herndon, VA area in support ... agencies. The person in this position serves as an Analyst and/or Case Manager for the Executive Order Mandated...for the Executive Order Mandated (EOM), FOIA, PA, and Appeals requests, from the receipt of the initial request… more
- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. **Position Summary** The Sr. Analyst , MHK Product Owner (PO) is responsible for leading the MHK product development and ... configuration for the Grievance & Appeals (G&A) Department. This role contributes to the product...with the ability to establish working relationships across the senior management team, business units, as well as with… more
- Jabil (St. Petersburg, FL)
- …vibrant and diverse communities around the globe. How will you make an impact? As a Senior Benefits Analyst , you will play a key role in the administration and ... the reporting and processing of monthly invoices. + Manage the Benefits Appeals process. + Perform audits of internal systems, payroll deduction files, provider… more
- Molina Healthcare (UT)
- **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements ... and contractual guidelines. + Partner with provider relations, Health plans and appeals teams to address recurring dispute trends and recommend systemic solutions. +… more
- IHG (Atlanta, GA)
- …process scope. **Your day to day** The Sales \ Use and Property Tax Analyst will be responsible for administering, reviewing, and analyzing sales, use and hotel ... related tax audits, minimizing audit assessments. + Assist with real estate tax appeals and personal property tax audits and compliance. + Provide verbal and written… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …remotly (Days, M- F). *Purpose of this position:*The Contract Variance Analyst Senior is responsible for leading the end-to-end appeals process related to ... **_SUMMARY_** We are currently seeking a *PFS Contract Variance Analyst Senior ** *to join our Denials Analysis team. This full-time role will work… more
- HCA Healthcare (Nashville, TN)
- … Analyst establishes and maintains monthly utilization and financial reporting. The Analyst will interact with senior leadership teams as needed. **Major ... **Description** **Introduction** Do you have the career opportunities as a Benefits Analyst you want with your current employer? We have an exciting opportunity for… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …will work remotely (Days, M- F). *Purpose of this position:*The Contract Variance Analyst provides foundational support in managing appeals related to payer ... **_SUMMARY_** We are currently seeking a *PFS Contract Variance Analyst ** *to join our Denials Analysis team. This full-time role… more
- City and County of San Francisco (San Francisco, CA)
- …right fit. The City and County of San Francisco is looking to hire multiple Senior Administrative Analysts to be part of the City workforce of nearly 40,000 staff ... has to offer. In the role of Principal Administrative Analyst , you will lead and perform challenging and complex...and organizational issues, and presenting findings and recommendations to senior management. You will also oversee key aspects of… more
- Deloitte (Los Angeles, CA)
- …+ Demonstrated ability to write clearly, succinctly, and in a manner that appeals to a wide audience. + Proficiency in word processing, spreadsheet, and presentation ... creation tools, as well as Internet research tools. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and… more
- The Cigna Group (Salem, OR)
- …Complete onsite quality assessments + Respond to provider inquiries, concerns, complaints, appeals and grievances + Provide ongoing product education to dentists and ... their staff + Work to achieve contract discounts with new providers and current providers through thoughtful negotiation + Use data and facts to identify and overcome objections + Prioritize and organize own work to meet deadlines, and reach established… more
- City and County of San Francisco (San Francisco, CA)
- …data, and safeguard sensitive employee information. Stakeholder Engagement + Act as the senior liaison between the People Technology team, ITT, and business users. + ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...regarding this recruitment or application process, please contact recruitment analyst Rie Butler at ###@flysfo.com (###@flysfo.com) . The City… more
