• Grievance/ Appeals Analyst Lead

    Elevance Health (Tampa, FL)
    …school diploma or GED equivalent and a minimum of 3 years of Grievance & Appeals Senior analyst experience; or any combination of education and experience which ... review, analyze and process pre service and post service grievances and appeals requests related to clinical...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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  • Senior Medical Director - Sharp Health Plan

    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
    Sharp HealthCare (04/20/25)
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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, ... of the Job: Under the limited direction of the Senior Director, Employee and Labor Relations, the Employee and...Employee and Labor Relations, the Employee and Labor Relations Manager , is responsible for managing day-to-day employee and labor… more
    University of Delaware (04/24/25)
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  • Senior Analyst, Network Relations

    CVS Health (Springfield, IL)
    …each and every day. **Position Summary** The Medicaid Network Provider Relations Manager oversees our Medicaid Provider Experience programs to oversee and maintain ... building. + Coordinate with Network Management to issue provider CAP + Monitor Grievances according NCQA standards categories (3 grievances per QTR), including… more
    CVS Health (05/04/25)
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  • Behavioral Health Compliance Manager

    Ventura County (Ventura, CA)
    …agencies as needed; + Serves as the compliance point of contact for grievances , appeals , and Notices of Adverse Benefit Determinations (NOABDs); + Supervises ... Behavioral Health Compliance Manager Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4774428) Apply  Behavioral Health Compliance Manager more
    Ventura County (03/17/25)
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  • HR Partner and Recruiting Supervisor

    Skookum Contract Services (Bremerton, WA)
    …do attitude". + Investigate, prepare documentation, and recommend Tessera's position on grievances , EEOCs, complaints, and appeals . Responds to employee relation ... to their disabilities + Works closely with Chief People Officer, HR Director, Senior HR Partner, and Recruiting Manager in ensuring recruitment methodologies and… more
    Skookum Contract Services (05/06/25)
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  • Key DSO Dental Account Manager

    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
    Guardian Life (04/25/25)
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  • Employee Relations Specialist & ADA Program…

    State of Colorado (Denver, CO)
    …and guidance on issues that relate to performance management, progressive discipline, employee grievances and appeals , and civil rights. You will also be the ... delivering HR-related training; + SHRM Certified Professional (SHRM-CP) or SHRM Senior Certified Professional (SHRM-SCP) credential, SPHR, or PHR; + Proven… more
    State of Colorado (05/02/25)
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  • Deputy Director - Departmental Hearings…

    MTA (New York, NY)
    …ensures effective and timely processing of investigations, pre-trial conferences, trials, union appeals and assists with answering grievances . The position is ... charged with providing advice to department heads and senior staff to ensure the consistency and standardization of dispute resolution among the various departments… more
    MTA (03/14/25)
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  • Staff Assistant

    Customs and Border Protection (Laredo, TX)
    …services. Your typical duties will include: Serving as an office manager and providing administrative analytical support for the organization Developing, devising, ... of issues/problems concerning functions that are the responsibility of the manager , schedules appointments and make all necessary arrangements for travel, meetings,… more
    Customs and Border Protection (05/02/25)
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