• CenCal Health (Santa Barbara, CA)
    …- $53.31 per hour Job Summary The expectation for the Member Services Specialist is to provide robust customer service for CenCal Health's CareConnect members and ... the Plan's strategic goals and Mission. In this role, the Member Services Specialist provides proactive and compassionate support to CenCal Health members. This role… more
    Upward (07/11/25)
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  • Grievance & Appeals

    Robert Half Accountemps (Los Angeles, CA)
    Description A Medical IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist . The Grievance & Appeals Specialist , ... denied claims, complying with State/Federal laws, rules, and guidelines. The Grievance & Appeals Specialist will be expected to perform research and… more
    Robert Half Accountemps (07/20/25)
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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, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
    LA Care Health Plan (07/08/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Appeals and Grievances Coordinator I supports the Customer Solution Center Appeals & Grievance Specialists by handling the administrative functions of the ... required by clinical staff to render decisions, assists the Customer Solution Center Appeals & Grievance Manager and Director in meeting regulatory timelines by… more
    LA Care Health Plan (07/22/25)
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  • Associate Medical Director - Genetic Testing

    Elevance Health (Los Angeles, CA)
    …necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures ... a health profession. **Preferred skills, capabilities, and experiences:** + Oncology specialist preferred + Internal medicine specialist preferred For candidates… more
    Elevance Health (07/02/25)
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