• Nurse Case Manager

    Actalent (Sacramento, CA)
    Description: + The Medi-Cal Member Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of ... a preservice, post-service or claim denial. + The Medi-Cal Appeals and Grievances senior RN will report to the... and Grievances senior RN will report to the Appeals and Grievances Manager. + In this role, you… more
    Actalent (05/29/24)
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  • Attorney / Hearing Officer

    State of Indiana (Indianapolis, IN)
    …in a cooperative manner that helps Hoosier taxpayers. The Hearing Officer resolves taxpayer appeals on both a formal and informal basis. You will resolve appeals ... other sections of DOR on the procedures of the Appeals section. A Day in the Life: The essential...appeal, including internal DOR research. + Fully resolve taxpayer appeals by issuing thoroughly researched and clearly written final… more
    State of Indiana (05/21/24)
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  • Deputy State Appellate Public Defender

    Idaho Division of Human Resources (Boise, ID)
    …and post-conviction proceedings arising out of those cases. The AU's role is limited to appeals before the Idaho Court of Appeals and/or the Idaho Supreme Court. ... in post-conviction proceedings in the trial court, and in appeals before the Idaho Supreme Court. The State Appellate...represents indigent clients in juvenile, misdemeanor, felony, and post-conviction appeals before the Idaho Court of Appeals more
    Idaho Division of Human Resources (05/21/24)
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  • Director - USFHP Clinical Operations

    Pacific Medical Centers (Seattle, WA)
    …security issues with the federal government. + Manages the integrity program and appeals process, including ongoing evaluation of the staff who research and prepare ... appeals for presentation. Decision maker for all post service, network and benefit appeals . Acts as second level manager for grievances. Works with patients and… more
    Pacific Medical Centers (05/18/24)
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  • Denials Senior Analyst

    R1 RCM (Detroit, MI)
    …calling insurance companies to resolve authorization and clinical claim denials, writing appeals and letters to insurance companies to resolve denials, following up ... on appeals to the point of exhaustion or payment and...payer follow-up via phone, portal or email. + Writes appeals and other correspondence to payers to overturn denials… more
    R1 RCM (05/18/24)
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  • Director, Strategic Communications Advancement

    College of Western Idaho (Nampa, ID)
    …all communication channels within the Advancement Division, develop and write appeals , and collaborate closely with the College's Marketing and Communications team. ... platforms to strengthen the College's brand and reputation. 4. Appeals Development and Writing: * Lead the development and...Writing: * Lead the development and writing of compelling appeals to secure financial support from donors. * Collaborate… more
    College of Western Idaho (05/11/24)
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  • Assistant Attorney General II

    Arkansas Government Job (Little Rock, AR)
    …Circuit Courts, Arkansas State Claims Commission, and Federal District Courts, as well as appeals to the Arkansas Supreme Court and Court of Appeals , and the ... Commission and Federal District Courts, as well as briefing appeals to the Arkansas Supreme Court and Court of... to the Arkansas Supreme Court and Court of Appeals and the Eighth Circuit Court of Appeals more
    Arkansas Government Job (04/30/24)
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  • Paralegal

    Amentum (Camp Springs, MD)
    …Paralegal to assist with the USCIS litigation support team on Visa Petition Appeals Records of Proceeding (ROP) and E-ROPs. Under close guidance and supervision, the ... case files are have complete, accurate and timely documentation including decisions, appeals processes, etc. to complete the following actions: + Update databases to… more
    Amentum (04/23/24)
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  • Lead Certification Analyst

    Transdev (San Francisco, CA)
    …in-person interview to arrive at a determination. Analysts also participate in any appeals hearing related to a contested determination. The person in this position ... team of analysts with guidance related to eligibility assessments, preparation for appeals hearings and other requests for consultation related to business that… more
    Transdev (04/19/24)
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  • Medical Director - Medical Affairs (Oncology)

    CVS Health (Springfield, IL)
    …Medical Director transacts Utilization Management UM activities (prior authorization and appeals ) and responds to prescriber inquiries related to UM transactions and ... completing assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental (Medicare/Medicaid) programs and individual… more
    CVS Health (04/16/24)
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