• Jobleads-US (Portland, OR)
    …employee complaints, policy violations, disciplinary actions, and employee and applicant appeals and grievances . Provides guidance and recommendations for ... HR experience with at least 5 years in a leadership role. A minimum of 3 years of labor relations experience in a union environment. Thorough knowledge of labor… more
    Appcast IO CPC (10/29/25)
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  • Unknown (Fremont, CA)
    …teamwork, and facilitation, as well as the ability to manage student appeals , grievances , and the admission process for qualified nursing students. ... the Campus Dean position must have a completed MSN and DNP, with a minimum of 3 years of nursing instructor experience. A current RN license in the state of the… more
    Appcast IO CPC (10/27/25)
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  • Registered Nurse (RN) Manager, Appeals

    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: ... required to achieve that purpose. Job Summary The Manager, Appeals & Grievances (A&G) & General Operations...years of clinical acute care experience with at least 3 years of experience with health care grievance and/or… more
    LA Care Health Plan (09/09/25)
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  • Director, Appeals and Grievances

    Sanford Health (Sioux Falls, SD)
    appeals and grievances , regulatory oversight, or health policy. At least 3 years in a leadership role managing appeals , grievances , or regulatory ... appeals and grievance resolution. Lead and manage the end-to-end appeals and grievances process for all product lines, ensuring compliance with federal and… more
    Sanford Health (09/29/25)
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  • Supervisor, Customer Solution Center…

    LA Care Health Plan (Los Angeles, CA)
    …Degree Experience Required: At least 3 years in a healthcare setting in Grievances and Appeals , Compliance, Claims or Call Center. At least 2 years of ... Supervisor, Customer Solution Center Appeals and Grievances (Temporary) Job Category: Management/Executive Department: CSC Appeals & Grievances Location:… more
    LA Care Health Plan (09/16/25)
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  • Coordinator Appeals & Grievances

    AmeriHealth Caritas (Philadelphia, PA)
    …more about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances , this position is responsible for the ... management + Monitors to ensure that all problems with appeals / grievances presented by plan members/participants are resolved...experience in a Managed Care environment + 1 to 3 years' experience in grievance/ appeals environment required… more
    AmeriHealth Caritas (10/09/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Yonkers, NY)
    …**Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers, ... to work 1 Saturday a month M-F from 7am - 3 :30pm CST will require to work 1 Saturday a...internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to… more
    Molina Healthcare (10/26/25)
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  • Coordinator, Appeals & Grievances

    Evolent (Nashville, TN)
    …or GED is required. + Minimum of 3 years' experience in an Appeals and Grievances role or comparable administrative role within a health plan, managed ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Appeals and Grievances ** at Evolent is responsible for reviewing and processing case requests,… more
    Evolent (10/11/25)
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  • Manager II Grievance & Appeals

    Elevance Health (Woodbridge, NJ)
    …an accommodation is granted as required by law._ The **Manager II Grievance & Appeals ** responsible for management oversight of grievances and appeals ... departmental units to investigate, resolve, and respond to grievances and appeals , manages inventory and production...degree and a minimum of 5+ years grievance & appeals experience and a minimum of 3 more
    Elevance Health (10/13/25)
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  • Clinical Appeals Supervisor (Hybrid)

    CareFirst (Baltimore, MD)
    …data and data related to the volume and complexity of the appeals and grievances submitted for resolution. **SUPERVISORY RESPONSIBILITY:** This position ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate implementation of the clinical appeal process for members… more
    CareFirst (10/15/25)
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