- Molina Healthcare (Rochester, NY)
- …years' experience in healthcare claims review and/or Provider appeals and grievance processing/resolution, including 2 years in a manager role. * Experience ... and DRG/RCC pricing), and IPA. + 2 years supervisory/management experience with appeals / grievance and/or claims processing within a managed care setting.… more
- CUNY (Brooklyn, NY)
- …assessment, BIT/student support case management, freedom of expression oversight, and grievance and appeals resolution. + Collaborate with various departments ... Manager of Student Advocacy and Accountability (HEA) **POSITION...conduct reports; coordinating the student conduct process, grievances, and appeals . + Oversee the Faculty Student Disciplinary Committee to… more
- MTA (Jamaica, NY)
- Senior Manager , Labor Relations Job ID: 12770 Business Unit: MTA Headquarters Location: Jamaica, NY, United States Regular/Temporary: Regular Department: Labor ... Posted: Aug 20, 2025 Description POSTING NO. 12770 JOB TITLE: Senior Manager , Labor Relations DEPT/DIV: Labor Relations WORK LOCATION: Jamaica, NY FULL/PART-TIME FUL… more
- Molina Healthcare (Rochester, NY)
- …procedures regarding compliance with local, state and federal guidelines. * Establishes member grievance appeals and policies and updates annually or as directed ... for Medicare and Medicaid Services. * Establishes non-contracted provider dispute and appeals policies and policies and updates annually or as directed by the… more
- Elevance Health (New York, NY)
- …necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more