• Manager , Grievance and Appeals , RN

    VNS Health (Manhattan, NY)
    …Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and grievances . + Ensures the accuracy and integrity of data ... of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the...Lead with Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long… more
    VNS Health (03/05/25)
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  • Appeals and Grievances Triage…

    Fallon Health (Worcester, MA)
    …other applicable regulatory requirements and member and provider expectations. The FH Appeals and Grievances Triage Administrator serves to administer the FH ... standards. The Triage Administrator is responsible for triaging and assigning all incoming appeals and grievances addressed to the Member Appeals &… more
    Fallon Health (03/26/25)
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  • Member Appeals and Grievance Intake…

    Fallon Health (Worcester, MA)
    …of Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Intake Administrator is responsible for triaging and ... assigning all incoming appeals and grievances...clerical/administrative responsibilities at the discretion of the Director or Manager . * Providing administrative assistance in support of the… more
    Fallon Health (04/15/25)
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  • Grievance/ Appeals Analyst Lead

    Elevance Health (Tampa, FL)
    …Department responsible to review, analyze and process pre service and post service grievances and appeals requests related to clinical and non clinical services, ... and analysis of complex pre service and post service grievances and appeals requests from customer and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (04/12/25)
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  • Clinical Appeals Manager (Hybrid)

    CareFirst (Baltimore, MD)
    …process with dynamic goals resulting in the full and fair review of appeals and grievances designed to achieve corporate objectives and advance departmental ... and accreditation requirements. Ensures appropriate and complete resolution of appeals , Regulatory complaints and External review requests. Performs analytics and… more
    CareFirst (05/04/25)
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  • Nurse Appeals Lead (RN)

    Elevance Health (Walnut Creek, CA)
    …serving as a team lead and for investigating and processing the most complex grievances and appeals requests from members and providers and provide leadership ... + Conducts investigations and reviews of member and provider grievances and appeals . + Reviews prospective or...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (05/06/25)
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  • Nurse Appeals Associate

    Elevance Health (Chicago, IL)
    …business leaders passionate about transforming American healthcare delivery. **Nurse Appeals Associate** **Location:** This role enables associates to work virtually ... pm CST. Must be able to rotate on mandatory holidays. The **Nurse Appeals Associate** is responsible for supporting the development and implementation of quality… more
    Elevance Health (05/03/25)
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  • Manager , Employee & Labor Relations

    University of Delaware (Newark, DE)
    Manager , Employee & Labor Relations Job no: 501883 College / VP Area:Office of Human Resources Work type: Staff Location: Newark/Hybrid Categories: Human Resources, ... Director, Employee and Labor Relations, the Employee and Labor Relations Manager , is responsible for managing day-to-day employee and labor relations functions.… more
    University of Delaware (04/24/25)
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  • Manager ROI Audit Research

    Beth Israel Lahey Health (Burlington, MA)
    grievances involving colleagues; interview and select, with the manager , candidates for employment.** **Proactively develop plans to meet future ... discusses issues with outside auditors and the inpatient coding manager /CDI. Prepares appeals on appropriate cases to...within the confines of said policies and . handle grievances appropriately.** **Listen to and respond to employee problems… more
    Beth Israel Lahey Health (02/14/25)
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  • CDOC Corrections Case Manager I (Buena…

    State of Colorado (Chaffee County, CO)
    CDOC Corrections Case Manager I (Buena Vista) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4921223) Apply  CDOC Corrections Case Manager ... Supervision, Individualized Program Instruction/Tutoring, Multi-Disciplinary Staffing, Responding to Offender Grievances and Resolving Offender Issues, Offender Housing Placement and… more
    State of Colorado (05/02/25)
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