• Medical Director - Utilization Management

    UPMC (Pittsburgh, PA)
    …improvement review processes, including concurrent, prospective and retrospective reviews, member grievances , provider appeals , and potential quality of care ... The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health… more
    UPMC (06/12/25)
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  • Director of Operations

    CVS Health (Kenner, LA)
    …multiple departments including but not limited to System Configuration, Claims, Encounters, Appeals & Grievances , Member Services, Provider Call Center, Network ... Mgt, Provider Experience, and Provider Data Services. **Required Qualifications** 10-15 years work experience. Proficient in Healthcare Service Operations including Lifecyle of a claim, adjudication system configuration, and provider data records. Experience… more
    CVS Health (07/20/25)
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  • Medical Director

    Highmark Health (Columbia, SC)
    …medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances , and other reviews as assigned. Compose clear ... and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with… more
    Highmark Health (07/16/25)
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  • CDOC Mid Level Provider / Nurse Manager - (Denver)

    State of Colorado (Denver, CO)
    …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... DOC departments; + Responsible for budget, reporting, conflict resolution, inmate grievances , and maintaining a comprehensive inmate medical record; + Responsible… more
    State of Colorado (07/25/25)
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  • CDOC Housekeeping Lieutenant Csts II (Sterling)

    State of Colorado (Sterling, CO)
    …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... and conducts performance evaluations; resolves informal staff and/or inmate grievances . Assigns tasks, monitors and inspects work progress and...Board or request a review by the State Personnel Director . An appeal or review must be submitted on… more
    State of Colorado (07/19/25)
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  • Correctional Youth Security Supervisor III…

    State of Colorado (Pueblo, CO)
    …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... ongoing professional development training (as available). Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in… more
    State of Colorado (07/23/25)
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  • Correctional, Youth, Supervisor III at CALM

    State of Colorado (Golden, CO)
    …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... professional development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in… more
    State of Colorado (07/22/25)
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  • Human Resources Business Partner

    State of Colorado (Denver, CO)
    …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes,… more
    State of Colorado (07/24/25)
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  • CDOC - Human Resources Specialist V (Human…

    State of Colorado (CO)
    …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... actions; develop performance plans and sign performance documents; resolve informal grievances ; provide coaching, mentoring, approve leave, manage workloads; + Serve… more
    State of Colorado (07/22/25)
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  • CDOC - Community Programs Specialist III…

    State of Colorado (Colorado Springs, CO)
    …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... Supervision, Individualized Program Instruction/Tutoring, Multi-Disciplinary Staffing, Responding to Offender Grievances and Resolving Offender Issues, Offender Housing Placement and… more
    State of Colorado (07/19/25)
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