• Grievance & Appeals…

    Centene Corporation (Phoenix, AZ)
    …member and provider complaints, grievances and appeals + Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals , claims, related managed care experience, or… more
    Centene Corporation (08/31/25)
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  • Appeals / Grievance…

    Sharp HealthCare (San Diego, CA)
    …and Grievance ProcessingUnder limited supervision, reviews and responds to appeals and grievances received from Commercial members and providers, in accordance ... documentation in department database to ensure accurate and thorough documentation of appeals / grievance process.Communicates both in written and oral form in a… more
    Sharp HealthCare (08/20/25)
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  • Appeals / Grievance…

    Sharp HealthCare (San Diego, CA)
    …and grievance processingUnder limited supervision, reviews and responds to appeals and grievances received from members and providers, in accordance with ... in IDX Customer Service Module to ensure accurate and thorough documentation of appeals / grievance process.Communicates both in written and oral form in a… more
    Sharp HealthCare (08/20/25)
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  • Appeals and Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator ... No **Essential Duties & Responsibilities** Processing of Grievances & Appeals : + Responsible for the progress of grievance... Appeals : + Responsible for the progress of grievance and appeal intervention and resolution. + Assure verbal… more
    Commonwealth Care Alliance (08/20/25)
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  • Appeal and Grievance Coordinator…

    CVS Health (Tallahassee, FL)
    …of responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance . Identify trends and emerging issues and ... report and recommend solutions. -Research incoming electronic appeals , complaints and grievance to identify if appropriate for unit based upon published business… more
    CVS Health (08/31/25)
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  • Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    …Appeals and Grievances Coordinator I supports the Customer Solution Center Appeals & Grievance Specialists by handling the administrative functions of the ... Customer Solution Center Appeals and Grievances Coordinator I(Temp) Job...staff to render decisions, assists the Customer Solution Center Appeals & Grievance Manager and Director in… more
    LA Care Health Plan (09/02/25)
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  • Patient Relations and Legal Coordinator…

    Roper St. Francis (Charleston, SC)
    …Day shift 8:00am-5:00pm** **Job Summary** **:** The Patient Relations & Legal Coordinator aids in complaints and grievances management as well as legal matters ... resolutions, receives & forwards compliments, issues acknowledgement letters, forwards grievance forms within the designated timeframe, assists with accreditation… more
    Roper St. Francis (08/27/25)
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  • Housing Care Coordinator

    CareOregon (Portland, OR)
    …Maintain working knowledge of COA and OHP benefits. + Report member complaints to Appeals and Grievance team for investigation and follow-up, per protocol. + ... and must comply with all federal laws. Job Title Housing Care Coordinator Exemption Status Non-Exempt Department Care Coordination Manager Title Care Team Supervisor… more
    CareOregon (08/21/25)
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  • Director Of Labor And Employee Relations

    City of New York (New York, NY)
    …engagement with Union Partners, and will serve as the Agency's Health & Safety Coordinator . Responsibilities include but are not limited to: - Serves as liaison to ... arise with CFB employees. - Serve as the CFB's grievance representative and administer the contractual grievance ...process. Serve as Hearing Officer for grievances and disciplinary appeals . Represent the agency at hearings before the Office… more
    City of New York (08/14/25)
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  • Associate Director of Safety Net

    State of Colorado (Denver, CO)
    …and quality. The position monitors the team's performance in reviewing grievance information, auditing providers and completing investigations. In this role, the ... of the department's action. For more information about the appeals process, the official appeal form, and how to...this position, please direct your inquiries to our ADAAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more
    State of Colorado (08/27/25)
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