• Specialist , Appeals

    Molina Healthcare (New Haven, CT)
    …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes. +… more
    Molina Healthcare (04/30/25)
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  • Appeals and Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... as well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is… more
    Commonwealth Care Alliance (05/21/25)
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  • Appeals & Grievances Program Advisor

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA...+ Communicate and work collaboratively with AG Representatives, Resolution Specialist and Management to maintain and improve quality of… more
    Commonwealth Care Alliance (05/21/25)
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  • Customer Solution Center Audit Readiness…

    LA Care Health Plan (Los Angeles, CA)
    …Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: ... call documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This… more
    LA Care Health Plan (05/29/25)
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  • CDOC Community Program Specialist III…

    State of Colorado (Denver, CO)
    CDOC Community Program Specialist III (Treatment Coordinator Case Manager) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4947774) Apply  CDOC ... Community Program Specialist III (Treatment Coordinator Case Manager) Salary $4,809.00 - $7,695.00 Monthly Location Denver, CO Job Type Full Time Job Number Den… more
    State of Colorado (05/21/25)
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  • Grievance Specialist I

    Martin's Point Health Care (Portland, ME)
    …+ 3+ years of experience in managed care plan; knowledge of grievances and appeals required Skills/Knowledge/Competencies (Behaviors): + Demonstrates an ... as a "Great Place to Work" since 2015. Position Summary The Grievance Specialist I plays a critical role in ensuring compliance within Health Plan operations.… more
    Martin's Point Health Care (05/30/25)
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  • Employee Relations Specialist (HR…

    State of Colorado (Denver, CO)
    Employee Relations Specialist (HR Specialist IV) - Metro Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4948842) Apply  Employee ... Relations Specialist (HR Specialist IV) - Metro Denver...advice and consultation to all stakeholders regarding employment issues, grievances , performance disputes, and HR issues. + Build credibility… more
    State of Colorado (05/21/25)
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  • Supervisory Human Resources Specialist

    Bureau of Naval Personnel (Millington, TN)
    …regarding assigned programs. You will manage the proper processing of employee appeals , complaints, and grievances . You will negotiate and draft collective ... Summary You will serve as a SUPERVISORY HUMAN RESOURCES SPECIALIST (EMPLOYEE RELATIONS/LABOR RELATIONS) in the BUREAU OF NAVAL PERSONNEL (BUPERS) DIVISION of BUREAU… more
    Bureau of Naval Personnel (05/31/25)
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  • Records Specialist 1 - SCI Waymart

    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 ... Records Specialist 1 - SCI Waymart Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4954994) Apply  Records Specialist 1 - SCI Waymart… more
    Commonwealth of Pennsylvania (06/01/25)
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  • Labor/Employee Relations Specialist I/ II/…

    Navy Exchange Services (NEX) (Virginia Beach, VA)
    Title: Labor/Employee Relations Specialist I/ II/ III (Non-competitive Progression) Location: United States-Virginia-Virginia Beach Job Number: 250000Q1 Note: This ... Summary: Under the guidance and supervision of a Labor/Employee Relations Specialist or Labor/Employee Relations Manager, responsible for providing technical support… more
    Navy Exchange Services (NEX) (05/02/25)
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