- Elevance Health (Atlanta, GA)
- **Grievance/ Appeals Analyst Senior ** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... skill development. Shift hours: 8:00am - 4:30pm EST** The **Grievance/ Appeals Analyst Senior ** is responsible for reviewing,...analyzing, and processing complex pre service and post service grievances and appeals requests in the Enterprise… more
- Sharp HealthCare (San Diego, CA)
- …as needed.Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight...needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'… more
- CHS (Clearwater, FL)
- …client trust. * Investigates and participates in formal responses relating to complaints, grievances and appeals received by or applicable to PAS. Participates ... **Overview** **Claims Manager ** **Servicing** **Health Insurance Policies or Benefits** **Summary:**...as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with… more
- Sacramento County (Sacramento, CA)
- Human Services Division Manager Range A/B Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2234944) Apply Human Services Division Manager ... $12,042.50 - $14,636.88/month Under executive direction, the Human Services Division Manager plans, coordinates and administers a human services division comprised… more
- LA Care Health Plan (Los Angeles, CA)
- …purpose. Job Summary The Technical Application Manager II reports to the Senior Manager Information Technology IT Solutions Delivery. This role acts as the ... Technical Applications Manager II Job Category: Information Technology Department: IT...of Membership Eligibility and Enrollment, Member Maintenance, PCP assignment, Appeals and Grievances preferred. EDI 5 years… more
- Guardian Life (Holmdel, NJ)
- …contact for all assigned DSOs. Respond to provider inquiries, concerns, complaints, appeals and grievances within assigned timeframes. Collaborate across teams ... Organization (DSO) partners. As a **Key DSO Dental Account Manager , Dental Support Organizations** , you will be responsible...financial reimbursement rates with DSOs + Make presentations to senior -level management of DSOs + Identify and report to… more
- Sharp HealthCare (San Diego, CA)
- …+ Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager to identify trends in ... care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief...the ability to interface effectively with employees, members, physicians, senior management, and the public at large. + Management… more
- Somatus (Mclean, VA)
- …Special Need Plans (SNPs). The Director, Quality will work closely with Sr. Manager , Audit Risk and the Regulatory and Accreditation Team to ensure compliance with ... audits, complaints/ grievances , and adherence to contractual obligations and Service Level...pre-delegation audits, annual client audits, development of grievance and appeals workflow processes, and other regulatory requirements. + Direct,… more
- University of Colorado (Boulder, CO)
- …concerns. Assists students with problem-solving and campus resources. Advances appeals or grievances to the senior program manager as appropriate. + ... degree conferrals at the end of every session. + Assists the Senior Online Program Manager in sending regular messages through CRM system and unlinked accounts.… more
Related Job Searches:
Appeals,
Appeals Grievances,
Appeals Manager,
Grievances,
Manager,
Manager Appeals Grievances,
Senior,
Senior Manager