• 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 ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… 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 ... of Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Coordinator serves as a liaison between FH… more
    Fallon Health (05/29/25)
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  • Lead Mid-Level Provider - Gilliam Youth Services…

    State of Colorado (Denver, CO)
    …+ 1 - 2 years + Less than a year 03 How many years of experience do you have as clinical supervisor ? + 2 or more years + 1 - 2 years + Less than a year 04 How ... of health care including physical, psychiatric, and dental maintenance. Clinical Management: Functions as the facility responsible health authority (RHA).… more
    State of Colorado (07/16/25)
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  • Lead Medical Support Assistant

    Veterans Affairs, Veterans Health Administration (Fredericksburg, VA)
    …Resolves simple, informal complaints of employees and refers others, such as formal grievances and appeals , to the supervisor or appropriate management ... on work in progress and reviewing completed work to see that the supervisor 's instructions on work priorities, methods, deadlines and quality have been met. Conducts… more
    Veterans Affairs, Veterans Health Administration (07/13/25)
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  • Data Entry Pharmacy Technician Mail Order

    Beth Israel Lahey Health (Westwood, MA)
    …information. Escalates calls to pharmacists for clinical inquiries and escalates grievances to supervisor . 7. Maintains new and existing patient profiles and ... Support health care providers with required prior authorization and required appeals . Manage all mail/delivery of Rx orders including addressing problems/issues with… more
    Beth Israel Lahey Health (07/12/25)
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