- Humana (Lansing, MI)
- …comprehensive analytic review of clinical documentation to determine if an a grievance , appeal or further request is warranted and then delivers final determination ... + Previous inbound call center or related customer service experience + Grievance and appeals experience + Prior experience interpreting Member Benefits and Medical… more
- Howmet Aerospace (Whitehall, MI)
- …policies for the hourly union workforce. + Investigates and resolves complaint/ grievance activity. + Reviews and/or prepares employment related documents related to ... schedule and assignments, and reviews program content. + Administer the grievance process, including classifying and recording grievances in the tracker, scheduling… more
- Henry Ford Health System (Detroit, MI)
- …bargaining agreements, advising management on contract provisions, and coordinating grievance and dispute resolution processes. Providing advice and counsel to ... using HRIS/tracking systems to monitor labor relations activities (such as grievance tracking or training completion) and ensuring follow-through. Project management… more
- Molina Healthcare (Detroit, MI)
- …subcontractors and enrollees. * Monitors all formal and informal grievances with Grievance personnel to identify trends or problem areas of access and care ... delivery. Assists enrollees in the grievance process at the HMO and State levels and monitors outcomes. * Provides timely written responses to inquiries; prepares… more
- Humana (Lansing, MI)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their ... assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational… more
- Fresenius Medical Center (Battle Creek, MI)
- …services that are available. + Reviews patient rights and responsibilities, grievance information (company and network) and other facilities policies with patient ... and Continuity of Care + Reviews Patient Rights and Responsibilities, Grievance Procedure & Important Numbers Handout, FKC Non-discrimination policy, DNR Statement… more
- Comcast (Plymouth, MI)
- …manages Employee Relations issues. Assists with employee counseling, discipline and grievance handling. + Recommends new approaches, policies and procedures to ... maintain efficient and effective services. + Manages direct reports. Ensures compliance with state, local and federal guidelines and policies to protect the business and it's employees. + Partners with management to ensure strategic HR goals, policies and… more
- Molina Healthcare (Detroit, MI)
- …claims appeals and grievances using support systems to determine appeal and grievance outcomes. + Requests and reviews medical records, notes, and/or detailed bills ... as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina Healthcare guidelines. + Responsible for meeting production standards set… more
- University of Michigan (Ann Arbor, MI)
- …belief, membership in any social or political organization, participation in a grievance or complaint whether formal or informal, medical conditions including those ... related to pregnancy, childbirth and breastfeeding, arrest record, or any other factor where the item in question will not interfere with job performance and where the employee is otherwise qualified. The University of Michigan agrees to abide by the… more
- Gentiva (Clinton Township, MI)
- …and cost reduction + Provide oversight of family satisfaction surveys, grievance resolution, and patient issue escalation + Collaborate with community partners, ... referral sources, physicians, and families + Lead performance evaluations, employee engagement, and corrective actions when needed + Support contract/vendor management and ensure marketing material compliance + Conduct quarterly and ad hoc supervisory visits,… more