- Humana (Albany, NY)
- …for our associates, members and providers. As the Resolution Team Operations Director ( Director , Grievance and Appeals ), you will be accountable for the ... The Resolution team handles all complaints for Humana, including formal grievances, appeals , inquiries and disputes. Our mission is to resolve these complaints… more
- Molina Healthcare (Yonkers, NY)
- …**Job Summary** Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and ... dispute/ appeals processing. * Establishes member and non-contracted provider grievance /dispute and appeals policies/procedures and updates annually or as… more
- Humana (Albany, NY)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....member population, or condition type. May also engage in grievance and appeals reviews. May participate on… more
- Humana (Albany, NY)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....member population, or condition type. May also engage in grievance and appeals reviews. May participate on… more
- Humana (Albany, NY)
- …not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy), and reviews for DME, genetic ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- MTA (Jamaica, NY)
- …other labor relations related tasks as deemed appropriate. Responsibilities: + Manage grievance and disciplinary cases appealed by the various unions to the Labor ... or modify decisions made by Department Heads/designees related to such appeals . Represent the LIRR at contract interpretation and disciplinary arbitrations. Prepare… more
- New York State Civil Service (Albany, NY)
- …case law. The incumbent serves as the Chancellor's representative in hearing appeals of disciplinary and contract grievances pursuant to the collective bargaining ... of the Assistant Vice Chancellor for Employee Relations, the Assistant Director of Employee Relations performs the following:- Supervises the administration of… more