- 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 ... Appeals & Grievances Location: Los Angeles, CA,...Specialist II is responsible for assisting the Appeal and Grievances Compliance, Training and QA Manager to… more
- J&J Family of Companies (Los Angeles, CA)
- …of America **Job Description:** Johnson & Johnson Innovative Medicine is recruiting for a Senior Regional Business Manager , Site of Care, to lead the West Coast ... such as eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ; practice management, as well as Medicare and… more
- Sacramento Municipal Utility District (Sacramento, CA)
- …in written Labor Relations work, including disciplinary documents, reports, responding to grievances or appeals **Physical Requirements** Applicants must be able ... Title: Senior Labor Relations Analyst Department: Employee Relations Location:...minimum qualifications listed in this posting. **Purpose** Assists the Manager , Labor Relations in the development, coordination, implementation, and… more
- Sharp HealthCare (San Diego, CA)
- …as needed.Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight...needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'… more
- CHS (Clearwater, FL)
- …client trust. * Investigates and participates in formal responses relating to complaints, grievances and appeals received by or applicable to PAS. Participates ... **Overview** **Claims Manager ** **Servicing** **Health Insurance Policies or Benefits** **Summary:**...as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with… more
- LA Care Health Plan (Los Angeles, CA)
- …purpose. Job Summary The Technical Application Manager II reports to the Senior Manager Information Technology IT Solutions Delivery. This role acts as the ... Technical Applications Manager II Job Category: Information Technology Department: IT...of Membership Eligibility and Enrollment, Member Maintenance, PCP assignment, Appeals and Grievances preferred. EDI 5 years… more
- Sharp HealthCare (San Diego, CA)
- …+ Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief...the ability to interface effectively with employees, members, physicians, senior management, and the public at large. + Management… more
- State of Colorado (Denver, CO)
- …function of the Air Pollution Control Division, reporting to and advising the Senior Director of Air Quality as the department's delegated Staff Authority. This is ... Serves as the principal strategic legislative advisor to the Senior Director of Air Quality Programs. It is responsible...APCD program staff, and the Public Affairs & Policy Manager to ensure timely and coordinated messaging, particularly during… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …, and complaints, refers complex matters to HR Employee Relations Specialist or Senior Manager of Employee Relations as required + Participates in training ... generalist work with 30%dedicated time committed to handling employee complaints, grievances , interactive processes, and disciplinary actions. + Experience with case… more
- Somatus (Mclean, VA)
- …Special Need Plans (SNPs). The Director, Quality will work closely with Sr. Manager , Audit Risk and the Regulatory and Accreditation Team to ensure compliance with ... audits, complaints/ grievances , and adherence to contractual obligations and Service Level...pre-delegation audits, annual client audits, development of grievance and appeals workflow processes, and other regulatory requirements. + Direct,… more