- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... candidate selected for this role MUST have recent experience with healthcare/managed care grievances + The candidate selected for this role must live in California… more
- Sanford Health (Sioux Falls, SD)
- …appeals and grievance resolution. Lead and manage the end-to-end appeals and grievances process for all product lines, ensuring compliance with federal and state ... the intake, review, resolution, and documentation of all appeals, complaints, and grievances to meet regulatory and operational standards. Ensure all cases are… more
- MTA (New York, NY)
- Director, Labor Relations, and Grievances - MTAPD/Security Job ID: 13597 Business Unit: MTA Headquarters Location: New York, NY, United States Regular/Temporary: ... 2025 Description POSTING NO. 13597 JOB TITLE: Director, Labor Relations, and Grievances - MTAPD/Security DEPT/DIV: Employment and Labor Relations WORK LOCATION: 2… more
- Fallon Health (Worcester, MA)
- …regulatory requirements and member and provider expectations. The FH Appeals and Grievances Triage Administrator serves to administer the FH Appeals and Grievance ... responsible for triaging and assigning all incoming appeals and grievances addressed to the Member Appeals & Grievances... grievances addressed to the Member Appeals & Grievances Department and Provider Appeals Department. This position will… more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... achieve that purpose. Job Summary The Lead Customer Solution Center Appeals and Grievances RN is responsible for assisting with the development of a successful and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I primary function is to learn the...function is to learn the specialty level appeals and grievances work supporting the higher level position in this… more
- Molina Healthcare (Tampa, FL)
- …Duties** * Facilitates comprehensive research and resolution of appeals, disputes, grievances , and/or complaints from Molina members, providers, and related outside ... and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and grievance outcomes.… more
- Modivcare (Ridgeland, MS)
- …may be the right fit for you! Modivcare is looking for an experienced Grievances & Appeals Specialist to join our team! This position is responsible for establishing ... for service failure. This role + Handles high-risk member complaints and grievances . + Collects all necessary supporting information to accurately provide a… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider… more
- Texas Health Resources (Dallas, TX)
- Program Manager - Complaints & Grievances (THPG) _Bring your passion to Texas Health so we are Better + Together_ Location: Dallas, TX Remote (with potential visits ... Texas Health is seeking a passionate Program Manager to lead our Complaints and Grievances program across 250+ clinics in the DFW area. This role supports patient… more
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