- Jobleads-US (Portland, OR)
- …employee complaints, policy violations, disciplinary actions, and employee and applicant appeals and grievances . Provides guidance and recommendations for ... bargaining agreement. The position supervises the Corporate Human Resource Manager , Benefits Administrator, and the Learning and Development Department. Reports… more
- Unknown (Reno, NV)
- …and teamwork. Responsibilities also include maintaining community relationships, managing student appeals and grievances , and ensuring that students are properly ... oriented to clinical facilities. Hiring Manager Title Dean, Chief Academic Officer Travel Percent Less than 10% Functions Education/Academic Administration Medical… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... support the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical) is responsible… more
- Molina Healthcare (South Charleston, OH)
- …Manages staff responsible for the submission/resolution of member and provider inquiries, appeals and grievances for the Plan. Ensures resolutions are compliant. ... tracking system of correspondence and outcomes for provider and member appeals / grievances ; oversees monitoring of each member submission/resolution to ensure… more
- Elevance Health (Woodbridge, NJ)
- …is granted as required by law._ The ** Manager II Grievance & Appeals ** responsible for management oversight of grievances and appeals departmental ... ** Manager II Grievance/ Appeals ** **- Claims Support**...units to investigate, resolve, and respond to grievances and appeals , manages inventory and production… more
- CareFirst (Baltimore, MD)
- …mandates. Directs the activities and serves as a resource for associates within the Appeals and Grievances Department for Government Programs. We are looking for ... training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in...data related to the volume and complexity of the appeals and grievances submitted for resolution. **SUPERVISORY… more
- Elevance Health (Atlanta, GA)
- …and forwards to Medical Director for final review and decision. + Ensures that appeals and grievances are resolved timely to meet regulatory timeframes. + ... skills and serves as a subject matter expert for appeals / grievances /quality of care issues and is a...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Charlotte, NC)
- …providers, and regulatory entities, and serves as a subject matter expert for appeals , grievances , and quality of care issues. + Key responsibilities: serves ... **Nurse Appeals - Litigation & Legal Support** **Location:** North...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Costa Mesa, CA)
- **Nurse Appeals RN-Quality of Care** **Location: California-Costa Mesa, Walnut Creek, or Woodland Hills** **Hybrid 1:** This role requires associates to be in-office ... Work Hours:** Monday-Friday, 8:00AM -5:00 PM Pacific Standard Time The **Nurse Appeals ** is responsible for investigating and processing and medical necessity … more
- Elevance Health (Metairie, LA)
- **Nurse Appeals RN-Quality of Care** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while ... Work Hours:** Monday-Friday, 8:00AM -5:00 PM Eastern Standard Time The **Nurse Appeals ** is responsible for investigating and processing and medical necessity … more
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