• Appeals & Grievances Analyst

    Point32Health (Watertown, MA)
    …colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for… more
    Point32Health (07/14/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will...Monitors closure of complaints and works with Quality Control Supervisor to resolve all database issues. Prepare and analyze… more
    LA Care Health Plan (07/08/25)
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  • 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...Federal and State Regulations. Complete individual summary scorecards for Supervisor feedback. + Track monthly scores on spreadsheet and… more
    Commonwealth Care Alliance (06/06/25)
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  • Supervisor , Clinical Grievance…

    Centene Corporation (Austin, TX)
    …oversight and interpretation of state/federal regulations and NCQA standards impacting member appeals and grievances from a clinical perspective. Ensure that the ... perspective on workplace flexibility. POSITION IS REMOTE THIS TEAM PROCESSES APPEALS ONLY Appeals Experience HIGHLY Preferred **Position Purpose:** Supervise… more
    Centene Corporation (07/10/25)
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  • Member Appeal & Grievance Coordinator-ACO-CC

    Fallon Health (Worcester, MA)
    …NCQA standards, other applicable regulatory requirements and member expectations. The FH Member Appeals & Grievances Coordinator serves to administer the FH ... departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Coordinator serves as a...rotational in-office calendar or at the direction of a supervisor or manager. Answers telephone calls via ACD queue,… more
    Fallon Health (05/29/25)
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  • CDOC General Maintenance Electrical…

    State of Colorado (Canon City, CO)
    CDOC General Maintenance Electrical Supervisor CSTS I (Canon City) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4992353) Apply  CDOC General ... Maintenance Electrical Supervisor CSTS I (Canon City) Salary $5,031.00 - $7,043.00...pay, creates schedule and assigns tasks and resolves informal grievances ; inspects work and performs inmate evaluations; reduces inmate… more
    State of Colorado (07/03/25)
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  • Employee & Labor Relations Specialist NF4 Regular…

    US Marine Corps (Quantico, VA)
    …investigations and leave administration. Performs and reviews trend analysis of grievances , unfair labor practices, complaints, and appeals , and develops ... be considered in effecting disciplinary actions, removals, suspensions, and in resolving grievances and appeals related to formal disciplinary actions taken and… more
    US Marine Corps (07/12/25)
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  • Human Resources Partner

    Skookum Contract Services (Colorado Springs, CO)
    …same. + Investigate, prepare documentation, and recommend Tessera's position on grievances , complaints, and appeals . Responds to employee relation issues ... such as employee complaints, harassment allegations, and grievances . Work with employees, employee representatives, Supervisors, Managers, and legal counsel to… more
    Skookum Contract Services (06/18/25)
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