• Appeals & Grievances

    Molina Healthcare (Yonkers, NY)
    …(CMS). **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals more
    Molina Healthcare (12/14/25)
    - Related Jobs
  • Appeals and Grievances Dismissal…

    Healthfirst (NY)
    …outreach through dismissal and complete verbal outreach attempts** + **Analyze incoming appeals and grievances to determine eligibility for dismissal based on ... School Diploma or GED from an accredited institution + Work experience with appeals and grievances or healthcare environment + Work experience requiring verbal… more
    Healthfirst (12/11/25)
    - Related Jobs
  • Standards Specialist

    City of New York (New York, NY)
    …of Correction ("DOC" or "the Department"); - Investigate serious incidents; - Review grievances from people in custody and staff; - Evaluate the performance of DOC; ... and change. JOB DESCRIPTION The Board seeks a Standards Specialist ("Monitor") with a passion for justice, fairness, and...the Minimum Standards by visiting jails, taking and resolving complaints from staff and people in custody - Examining… more
    City of New York (12/12/25)
    - Related Jobs
  • RN Medical Review Nurse Remote

    Molina Healthcare (Albany, NY)
    …to provide quality and cost-effective member care. This position will be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with ... The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory… more
    Molina Healthcare (12/03/25)
    - Related Jobs