• Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    …Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints and ... Customer Solution Center Appeals and Grievances Specialist ...experience in Managed Care with specific experience in resolving member and provider complaint and appeals issues,… more
    LA Care Health Plan (07/08/25)
    - Related Jobs
  • Specialist , Appeals

    Molina Healthcare (Omaha, NE)
    Appeals and IRE experience** **Job Summary** Responsible for reviewing and resolving member appeals and communicating resolution to members and provider (or ... + Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers… more
    Molina Healthcare (06/26/25)
    - Related Jobs
  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Coordinator I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center … more
    LA Care Health Plan (07/22/25)
    - Related Jobs
  • Appeals and Grievances Program…

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA...+ Communicate and work collaboratively with AG Representatives, Resolution Specialist and Management to maintain and improve quality of… more
    Commonwealth Care Alliance (06/06/25)
    - Related Jobs
  • Appeals and Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... Communicate and work collaboratively with CCA departments to help manage and resolve member appeals and grievances . + Act as a liaison between multiple… more
    Commonwealth Care Alliance (05/21/25)
    - Related Jobs
  • Customer Solution Center Audit Readiness…

    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
    LA Care Health Plan (07/17/25)
    - Related Jobs
  • CDOC - Human Resources Specialist V (Human…

    State of Colorado (CO)
    CDOC - Human Resources Specialist V (Human Resources Manager) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4994350) Apply  CDOC - Human ... Resources Specialist V (Human Resources Manager) Salary $7,610.00 - $12,177.00...Defined + Contribution Plan plus 401K and 457 plans. Member Contribution Rates . Correctional Officers I-IV qualify as… more
    State of Colorado (07/22/25)
    - Related Jobs
  • CDOC - Community Programs Specialist III…

    State of Colorado (Colorado Springs, CO)
    CDOC - Community Programs Specialist III (Re-Entry) - CO Springs Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5011224) Apply  CDOC - ... Community Programs Specialist III (Re-Entry) - CO Springs Salary $4,906.00 -...Defined + Contribution Plan plus 401K and 457 plans. Member Contribution Rates . Correctional Officers I-IV qualify as… more
    State of Colorado (07/19/25)
    - Related Jobs
  • Customer Solution Center Training Development…

    LA Care Health Plan (Los Angeles, CA)
    Specialist III Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... working in an Agile or fast-paced environment. Preferred: Experience with Appeals and/or Grievances . Experience measuring learning effectiveness and applying… more
    LA Care Health Plan (07/06/25)
    - Related Jobs
  • Clinical Reviewer

    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
    Independent Health (07/09/25)
    - Related Jobs