- Dignity Health (Rancho Cordova, CA)
- …This position is hybrid in-office and work from home.** **Position Summary:** The Appeals and Grievances Coordinator is responsible for supporting the ... regulatory requirements - facilitating timely and effective resolution of appeals and grievances . Acting a subject matter...grievances . Acting a subject matter expert (SME), the Coordinator will work closely with internal teams and external… more
- CVS Health (Springfield, IL)
- …+ Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs to ... Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs… more
- CVS Health (Baton Rouge, LA)
- …Summary Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs ... Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs… more
- CVS Health (Carson City, NV)
- …quality measures, with respect to letter content and turn-around time for appeals , complaints and grievances handling. -Independently researches and translates ... 9am-1pm.** Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may… more
- CoreCivic (Mason, TN)
- …a responsibility to better the public good. We are currently seeking a **Grievance Coordinator ** who has a passion for providing the highest quality care in an ... making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures that both informal and… more
- Cedars-Sinai (Beverly Hills, CA)
- …the payor + Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate ... About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient...the Inpatient Specialty Program (ISP) hospitalists, the RN Care Coordinator will assist patients from the time they are… more
- Elevance Health (Port St. Lucie, FL)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Bilingual in Spanish/English)** **Schedule:** Monday-Friday 8am-5pm **Location**...is granted as required by law._ The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
- Elevance Health (Chillicothe, OH)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Case Manager)** **Hiring near Cambridge, Colerain, Chillicothe,...services and supports, and psychosocial needs. The **LTSS Service Coordinator ** is responsible for managing service coordination for a… more
- Highmark Health (Nashville, TN)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical ... staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification… more
- State of Colorado (Golden, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more