- Molina Healthcare (Yonkers, NY)
- …and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of the Appeals & Grievances unit that is responsible for reviewing and ... organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving...monitoring and training of local plans' provider dispute and appeals units to ensure adherence with Medicare standards and… more
- Molina Healthcare (New York, NY)
- …reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + ... **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to the… more
- Molina Healthcare (New York, NY)
- …reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more
- Molina Healthcare (New York, NY)
- …for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances . * Coordinates with Corporate and Business ... Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). * Helps develop and… more
- City of New York (New York, NY)
- …a short window of time to issue a determination. The Associate will assist the Director of Appeals with handling visit restriction complaints and appeals ... Department of Correction" - Investigate serious incidents - Review grievances from people in custody and staff - Evaluate...with institutional security considerations to make recommendations to the Director of Appeals regarding the outcome of… more
- City of New York (New York, NY)
- …of Correction" Investigate any matter within the jurisdiction of the Department Review grievances from person in custody and staff Evaluate the performance of the ... on areas of key correctional planning. UNIT DESCRIPTION: The Board's Executive Director (ED) oversees a 31-person staff and a $3 million annual operating… more
- City of New York (New York, NY)
- …the Uniform Commercial Code ("UCC"); 10) assist division staff with procurement appeals and decision process, including draft opinions and presenting facts and ... to the Agency Chief Contracting Officer and agency staff; and 11) assist Director of Labor Relations, Human Resources, and others on issues pertaining agency… more
- City of New York (New York, NY)
- …the Uniform Commercial Code ("UCC"); 7) assist division staff with procurement appeals and decision process, including draft opinions and presenting facts and ... decisions to the Agency Chief Contracting Officer and agency staff; 8) assist Director of Labor Relations, Human Resources, and others on issues pertaining agency… more
- City of New York (New York, NY)
- …eligible low-income families for decent, safe, and affordable housing. HPDs Section 8 Appeals Unit manages and conducts informal hearings and reviews, which are the ... the Section 8 Program. Your Role: The role of the Deputy Director of OILR will be conducting investigations, supervising subordinate staff investigating allegations… more
- City of New York (New York, NY)
- …Contracting Officer (ACCO) and agency procurement staff in relation to procurement appeals and decision process, including draft opinions and the presentation of ... facts and decisions 8) assistance to the agency's Director of Labor Relations, Human Resources, and agency management on issues pertaining agency employees, locals… more
- City of New York (New York, NY)
- …of Correction ("DOC" or "the Department"); - Investigate serious incidents; - Review grievances from people in custody and staff; - Evaluate the performance of DOC; ... the jails. The Monitor will report to their assigned Director . Responsibilities include, but are not limited to: -...- Assisting in processing, evaluating and preparing responses to appeals from people in custody concerning the Minimum Standards… more