- LA Care Health Plan (Los Angeles, CA)
- …collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory ... retrospective review process for authorizations and Member or Provider Appeals , including, but not limited to computer data entry,...nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances and Appeals … more
- City and County of San Francisco (San Francisco, CA)
- …recruiting to fill the position of SES Assistant Superintendent (0932 Manager IV) San Francisco Public Works (https://www.sfpublicworks.org/) has a far-reaching ... Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'...position description, the minimum qualifications and/or the certification rule. Appeals must include a written statement of the item(s)… more
- The County of Los Angeles (Los Angeles, CA)
- …work objectives. Work under general supervision of the line or division manager . Acceptable classes for Staff Capacity experienceMAY include but are not limited ... I Accountant II Administrative Assistant I Administrative Assistant I, SC Appeals Hearing Specialist Board Specialist Employment Services Assistant I Financial… more
- Elevance Health (CA)
- …by providing clinical leadership and oversight across utilization management, appeals , and program innovation. This position ensures timely, appropriate, and ... and quality. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical...the United States when conducting utilization review or an appeals consideration and cannot be located on a US… more
- Sacramento County (Sacramento, CA)
- …the Clerk of the Board and acts as Clerk of the County Assessment Appeals Board, the County Planning Commission and other joint powers agencies. Incumbents in this ... Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days...Worker Compensation, etc. + Making operational decisions in your manager 's absence 08 Select all the boxes that best… more
- Stanford University (Stanford, CA)
- …the centers and staff, and posted on the Global HR website, within the HR Manager Toolkit and the Stanford Admin Guide. + Reporting, finance, and analysis + Receive ... for enhancing global benefit programs. + Reviews initial and second-level appeals relating to global benefit plan eligibility and/or contributions and makes… more
- City and County of San Francisco (San Francisco, CA)
- …evaluation and planning. As an Administrative Analyst, you may work with a manager to perform research to develop effective recommendations, identify issues and use ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Sharp HealthCare (San Diego, CA)
- …policy as needed. + Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager to identify trends ... care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief...Program and Quality Improvement Program, in conjunction with the Manager Medical Management and Quality Improvement Manager .… more
- Sacramento County (Sacramento, CA)
- …Service Commission, 700 H Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days after notice of the ... + Position held + From and to dates + Manager /supervisor name and contact information. If you selected "No...+ Position held + From and to dates + Manager /supervisor name If you selected "No experience", write "None".… more
- Sacramento Municipal Utility District (Sacramento, CA)
- …minimum qualifications listed in this posting. **Purpose** Assists the Manager , Labor Relations in the development, coordination, implementation, and administration ... and Responsibilities** + Provides analytical data and other information to the Manager , Labor Relations for negotiations with Union representatives in order to reach… more