- 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
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …process for LDH, while also supporting critical statewide programs including grievances , EEOC matters, Civil Service appeals , ADA accommodations, Affirmative ... for managers, supervisors, and employees to ensure compliance. + Investigates employee grievances , Civil Service appeals , and EEOC complaints; prepares findings… more
- LA Care Health Plan (Los Angeles, CA)
- … Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... to achieve that purpose. Job Summary The Customer Solution Center Training Specialist II is responsible for conducting functional training Customer Solution Center… more
- Independent Health (Buffalo, NY)
- …responsible for the collection and review of medical records specific to quality complaints/ grievances and appeals as indicated in support of a high performing ... plan and physician network. The Clinical Reviewer will investigate quality complaints/ grievances and appeals , document research of initial coverage… more
- State of Colorado (Limon, CO)
- …plans, and conducts performance evaluations; resolves informal staff and/or inmate grievances . Assigns tasks, monitors and inspects work progress and ensures ... inmate hours and pay, creates schedule and assigns tasks and resolves informal grievances according to agency policy; reduces inmate idleness and creates real life… more
- The Cigna Group (Tallahassee, FL)
- …Complete onsite quality assessments + Respond to provider inquiries, concerns, complaints, appeals and grievances + Provide ongoing product education to dentists ... procedures to routine instructions that require professional knowledge in specialist areas. Provides standard professional advice and creates initial… more
- State of Colorado (Denver, CO)
- …promotes a safe and secure environment. Supervision - provides supervisory or work lead duties for assigned inmate workers; promotes a high level of performance by ... pay, creates schedule and assigns tasks and resolves informal grievances according to agency policy; reduces inmate idleness and...with other staff members and inspire teamwork. + Supervisory/Work Lead Skills - ability to motivate inmates to work… more
- CVS Health (Springfield, IL)
- …Integrated Product Experience + Experience with Part D Coverage Determination, Appeals and Grievances and/or Formulary Administration regulatory requirements and ... **What you will do** + Acts as a top-level specialist on project management and develops a comprehensive plan...D reporting requirements + 3+ years serving as project lead + Adept at problem solving and decision making… more
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