• Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II...This position will focus on quality review of non-clinical grievance and appeals cases for all line… more
    LA Care Health Plan (08/29/25)
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  • Authorization Technician II

    LA Care Health Plan (Los Angeles, CA)
    …all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances and Appeals response letters ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location:...required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in… more
    LA Care Health Plan (08/29/25)
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  • Medical Services Coordination Specialist I/…

    Excellus BlueCross BlueShield (Rochester, NY)
    …referrals generated to care management programs + Provides administrative support to the grievance and appeals process within the + Medical Services department ... assigned to non-care managers are monitored by the care manager + The care manager provides feedback...+ Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) + Prioritizes… more
    Excellus BlueCross BlueShield (08/27/25)
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