- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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