- Tufts Medicine (Boston, MA)
- …communities healthy, and bring research breakthroughs to life. **Job Overview** The Senior Employee & Labor Relations Specialist serves as a trusted subject matter ... knowledge of healthcare-specific regulations (eg, HIPAA, Joint Commission standards). The senior specialist plays a critical role in shaping a fair, respectful,… more
- State of Colorado (Denver, CO)
- Senior Staff Accountant Supervisor Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5164739) Apply Senior Staff Accountant Supervisor ... candidate and hire. + Resolve problems, performance issues, disputes, and informal grievances and initiate corrective action or recommend discipline as needed. +… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …works closely with CPR's Director and Clinical Lead, Operations Lead, Senior Credentialing Manager / Compliance Consultant, Risk Specialist, Exception Review ... Specialists and Project Manager . This position is eligible for our Resident, Mobile,...subscriber certificates and apply to the investigation of member grievances . + Manage the fair hearing process for cases… more
- State of Colorado (Pueblo, CO)
- …without help. How do you handle this situation? 09 Katherine is a young Unit manager . Most of her staff nurses are senior to her, very articulate, confident, ... Nurse Manager - Mid Level Provider - CMHHIP Nursing- Pueblo...actions, signing performance plans and appraisals, and resolving informal grievances at the lowest level. + Draft and deliver… more
- Centene Corporation (Columbus, OH)
- …division of financial responsibility interpretation, contract rate and language interpretation, appeals , grievances and eligibility. + Serve as primary point ... groups, and/or ancillary providers within assigned area. + Act as account manager for assigned groups acting as gatekeeper for interactions with other internal… more
- CHS (Clearwater, FL)
- …client trust. * Investigates and participates in formal responses relating to complaints, grievances and appeals received by or applicable to PAS. Participates ... **Overview** **Claims Manager ** **Servicing** **Health Insurance Policies or Benefits** **Summary:**...as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with… more
- LA Care Health Plan (Los Angeles, CA)
- …purpose. Job Summary The Technical Application Manager II reports to the Senior Manager Information Technology IT Solutions Delivery. This role acts as the ... Technical Applications Manager II Job Category: Information Technology Department: IT...of Membership Eligibility and Enrollment, Member Maintenance, PCP assignment, Appeals and Grievances preferred. EDI 5 years… more
- Guardian Life (Phoenix, AZ)
- …contact for all assigned DSOs. Respond to provider inquiries, concerns, complaints, appeals and grievances within assigned timeframes. Collaborate across teams ... Organization (DSO) partners. As a **Key DSO Dental Account Manager , Dental Support Organizations** , you will be responsible...financial reimbursement rates with DSOs + Make presentations to senior -level management of DSOs + Identify and report to… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …, and complaints, refers complex matters to HR Employee Relations Specialist or Senior Manager of Employee Relations as required + Participates in training ... work with 20+% dedicated time committed to handling employee complaints, grievances , interactive processes, and disciplinary actions. + Familiarity with case… more
- Healthfirst (NY)
- …but not limited to Care Management, Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to align utilization decisions** + **Partner ... leadership experience in healthcare management including work experience in a mid- senior management role** + **Work experience and deep familiarity of health… more
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