- Elevance Health (Tampa, FL)
- ** Grievance / Appeals Analyst Lead** **Candidates must be located within 50 miles an Elevance Health PulsePoint office. This position is primarily work from home ... you to work in the office quarterly.** **Schedule: Monday-Friday 8am-5pm EST** The ** Grievance / Appeals Analyst Lead** is responsible for leading and coaching a… more
- VNS Health (Manhattan, NY)
- …to established procedures. Maintains confidentiality of information. + Maintains knowledge of Grievance and Appeals (G&A) procedures, and CMS and DOH regulatory ... health care organization required + Knowledge of DOH and CMS Grievance and Appeals regulatory requirements and procedures for ensuring compliance preferred +… more
- Centene Corporation (Phoenix, AZ)
- …Bachelor's degree in related field or equivalent experience. 2+ years of grievance and appeals experience in a Healthcare or Managed Care ... support and direction for the daily operations of the appeals function + Provide consultation for problem resolution for... function + Provide consultation for problem resolution for appeals staff and monitor team work output to ensure… more
- VNS Health (Manhattan, NY)
- …navigating the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our ... grievance and appeals processes. You will play a crucial role in...assure all are educated and compliant with requirements of appeals and grievance regulations and processing. +… more
- Point32Health (MA)
- …partners, colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- Fallon Health (Worcester, MA)
- …us on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance ... other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH Appeals… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written ... complaints, grievances and requests for appeals that involve complex matters submitted by Members and...of all regulatory requirements as they apply to complaint, grievance and appeal processes. + Proficient in Microsoft applications,… more
- CVS Health (Hartford, CT)
- …ABMS Recognized Specialty Preferred Qualifications * Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly ... Medical Director role are related to Part C Medicare Appeals . This position is primary on the non-regulated ...Appeals . This position is primary on the non-regulated appeals team, however the expectation is to cross train… more
- AmeriHealth Caritas (Philadelphia, PA)
- …with the member or their advocates to understand the full intent of the appeals or grievance .; ; **Education & Experience:** + Bachelor's Degree or equivalent ... services. ;Discover more about us at www.amerihealthcaritas.com. **Position Overview:** The Appeals Specialist reports to the Supervisor of Appeals &… more
- Fallon Health (Worcester, MA)
- …For more information, visit fallonhealth.org. **Brief Summary of Purpose:** Fallon Health's (FH) Appeals and Grievance process is an essential function to FH's ... and Grievances Triage Administrator serves to administer the FH Appeals and Grievance process as outlined in the FH Member Handbook/Evidence of Coverage,… more
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