- City of Jacksonville (Jacksonville, FL)
- …+ Participates in collective bargaining. + Handles labor disputes including grievances , arbitrations, unfair labor practices, and other related matters. + Reviews ... cases, hearings and at various internal board hearings and appeals . + Attends meetings of the City Council, boards,...of a Florida license to practice law. + Three ( 3 ) years of progressively responsible experience in the practice… more
- MTA (New York, NY)
- …Authority is North America's largest transportation network, serving a population of 15. 3 million people across a 5,000-square-mile travel area surrounding New York ... relations issues such as contract interpretation, disciplinary matters , medical appeals , Civil Service Law, and matters affecting Authority-wide policy and… more
- Commonwealth of Pennsylvania (PA)
- …Maintains inmate files for compliance with applicable laws and regulations and tracks appeals , misconducts, and grievances in electronic databases and paper case ... files. Updates inmate files with all corresponding legal documents when necessary and files appropriately. Ensures files contain all legally required documentation. Levels of Performance Select the Level of Performance that best describes your claim. + A. I… more
- Elevance Health (Tucson, AZ)
- …relevant parties of all prior authorization determinations. + Provides resolution to grievances and appeals issues. + Responds to inquiries from physicians, ... Tech I** **Location:** This role requires associates to be in-office [ 3 ] days per week, fostering collaboration and connectivity, while providing flexibility… more
- Insight Global (Mayfield Heights, OH)
- …Authorization/Gold Carding, Eligibility/Benefits Verification, Claim Submission, Adjudication, Payment, Appeals / Grievances ) * Clear and confident communicator, ... to code from. -The company is anticipated to double in size over the next 3 years. There is a lot of opportunity and growth occurring, as well as re-evaluation… more
- Insight Global (San Francisco, CA)
- …to change - thrives in a fast-moving, start-up environment Experience with grievances , appeals , or quality assurance within healthcare operations Background in ... Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and Requirements 3 + years of experience in customer support, operations, or… more
- AmeriHealth Caritas (Washington, DC)
- …requirements, including call center SLAs, member and provider grievance & appeals , claims timeliness, provider credentialing, UM turnaround times. + Responsible to ... efforts with the Medical Affairs and Provider Services departments regarding complaints and grievances pertaining to quality of care or providers. + Other duties as… more
- Elevance Health (Norfolk, VA)
- …Dental, Transportation) strongly preferred + Experience with Medicaid and Medicare grievances and appeals processes + Experience with network development ... **Required Qualifications:** + Requires a BA/BA degree and a minimum of 3 years of business analysis, process improvement, project management, network management or… more
- UnityPoint Health (Des Moines, IA)
- …employee relations problems, such as working conditions, disciplinary actions, and employee appeals and grievances . + Responds effectively to employee relations ... degree in Human Resource Management or related field required. Experience: 3 + years' experience of Employee Relations experience required, including conducting… more
- CVS Health (Springfield, IL)
- …Integrated Product Experience + Experience with Part D Coverage Determination, Appeals and Grievances and/or Formulary Administration regulatory requirements and ... audit management + Experience with Part C & D reporting requirements + 3 + years serving as project lead + Adept at problem solving and decision making + Experience… more