- Centria Autism (Tempe, AZ)
- …Area Director of Clinical Services will collaborate with the Area Operations Director on driving growth, overseeing performance standard metrics, ensure ... for escalated clinical matters and partner with the Area Operations Director as needed to make decisions...related to clinical services, including assessment denials, claims, and appeals . Escalate support needs as necessary to the Vice… more
- Centria Autism (Tempe, AZ)
- …Area Director of Clinical Services will collaborate with the Area Operations Director on driving growth, overseeing performance standard metrics, ensure ... for escalated clinical matters and partner with the Area Operations Director as needed to make decisions...related to clinical services, including assessment denials, claims, and appeals . Escalate support needs as necessary to the Vice… more
- Point32Health (Canton, MA)
- …. **Job Summary** Under the general direction of the VP, the Appeals and Grievances Director is responsible for management and oversight ... of the Enterprise Member Appeals and Grievances Department. The Director is...for; directing, leading, and modifying the business processes and operations for member appeals and member grievances… more
- Penn Medicine (Bala Cynwyd, PA)
- …**Hours: (must live reasonable distance from location)** M-F, 8:30AM -5:00PM The Director for Hospital Billing Compliance and Government Audits/ Appeals directs ... activities of all individuals throughout UPHS involved in record requests and appeals . In addition, the Director chairs the interdisciplinary External Audit… more
- Office of the Secretary of the Interior (Arlington, VA)
- …Veterans preference does not apply to the Senior Executive Service (SES). Responsibilities The Director Office of Hearings and Appeals is located in the Office ... The incumbent carries out the following specific responsibilities: 1. The Director exercises program management and administrative responsibilities with respect to… more
- CareFirst (Baltimore, MD)
- …of the Clinical Medical Claims Review, Medical Underwriting, Medical Policy, Clinical Appeals and Analysis programs and Quality of Care Complaint Unit. May lead ... that week. **ESSENTIAL FUNCTIONS:** + Directs the Medical Review and Appeals units and manages multiple strategic clinical projects that span organizational… more
- CVS Health (New York, NY)
- …decision support tools that provide actionable insights into organizational operations . + Confers with executives, clinicians, researchers, and administrators, to ... and AI, to generate measurable business impact. + Experience in Healthcare operations (payer and/or provider) Preferred Qualifications + Master's Degree or PhD… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting… more
- Corewell Health (Grand Rapids, MI)
- …departments. Serves as a mentor/trainer to other team members. The Senior Appeals Analyst makes decisions on moderately complex issues regarding technical approach ... Essential Functions + Responsible for complex and thorough investigation of appeals , external complaints, and fair hearing reviews including: formulate action plan… more
- Board of Veterans Appeals (Washington, DC)
- …team, directly supports the Vice Chairman in the management of the day-to-day operations of the Board of Veterans' Appeals . Ensures Board decisions comply ... progressively responsible management or executive level assignments such as director of a regional office, medical facility or program...legal work and provide legal advice pertaining to the operations of the Board of Veterans' Appeals ,… more
- Social Security Administration (Washington, DC)
- Summary The Deputy Executive Director (DED) for Appellate Operations (OAO) serves as full deputy and "alter ego" to the Executive Director . The incumbent ... shares full responsibility with the Executive Director and collaborates in all functions of the Office,...executive direction and leadership over the day-to-day activities and operations of the Appeals Council and its… more
- Pacific Medical Centers (Seattle, WA)
- **Description** **Overview:** The director provides leadership for USFHP clinical operations : including care management and the clinical quality management ... program. In collaboration with the Executive Director , develops and implements policies and procedures, staff training materials, and process protocols. Oversight… more
- State of Colorado (Denver, CO)
- Medicaid Operations Office Deputy Director Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4512501) Apply Medicaid Operations Office ... backgrounds and abilities. We are looking for a Medicaid Operations Office Deputy Director to j oin...Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals… more
- City and County of San Francisco (San Francisco, CA)
- …of the Ports Finance and Administration Division, the Information Systems (IS) Director plans, directs, and coordinates information system operations and ... and fish processing/distribution, tourism, filming, harbor services, and cruise operations . With some of the most flexible cargo handling...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director… more
- City and County of San Francisco (San Francisco, CA)
- …service examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service ... reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to the Executive Officer of… more
- City and County of San Francisco (San Francisco, CA)
- …reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to the Executive Officer of ... provides a range of mental health and substance use treatment services. The Director of the DPH Office of Contracts Management and Compliance will oversee contract… more
- Johns Hopkins University (Baltimore, MD)
- Reporting to the Peabody Executive Director of Enrollment Management, we are seeking a **_Director of Financial Aid_** who will supervise the daily operations of ... students and their families throughout the financial aid application process. The Director is responsible for determining a student's eligibility for aid, following… more
- University of Rochester (Rochester, NY)
- …and leaders in the College Center for Advising Services, the Assistant Director develops, executes, and assesses plans that improve current academic advising ... meeting institutional goals for student retention and timely graduation. The Assistant Director provides guidance and training to other academic advisors within the… more
- Montana State University (Bozeman, MT)
- …goals, is responsible for large donor cultivation, and directs or supports campaigns and appeals . The Director is a critical member of the museum's leadership ... please contact: Chris Dobbs, ###@montana.edu, ### Classification Title Managing Director Working Title Director of Development and...donor base. + Develop and implement annual and special appeals as needed, and under the leadership of the… more
- State of Colorado (Golden, CO)
- …of this position: The purpose of this position is to act as the Clinical Director for operations at Summit Youth Services Center and oversee the mental health ... Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes,… more
