- Healthfirst (NY)
- …+ Independently manage a caseload of grievances through the full case lifecycle, from written acknowledgement to investigation, resolution, and written member ... resolution letters. + Conduct detailed research by collaborating cross-functionally with internal departments (eg, Member Services, Provider Operations, Clinical, Enrollment, Pharmacy) to identify root causes and recommend appropriate resolutions. + Partner… more
- University of Rochester (Rochester, NY)
- …policy, procedures, program and labor contract interpretation, complaint and grievance handling, corrective discipline, dispute resolution and union recruitment. ... coordinates work of lower level staff. **ESSENTIAL FUNCTIONS** + Conducts formal grievance investigations and hearings and writes third step grievance responses… more
- New York State Civil Service (Tupper Lake, NY)
- …People With Developmental Disabilities, Office for Title Human Resources Specialist 1 Labor Relations/Trainee 1/2 Occupational Category Administrative or General ... Description PRIMARY DUTIES AND RESPONSIBILITIES: Under the supervision of a Human Resources Specialist 2 (LR), the Human Resources Specialist 1 (LR) in this… more
- Highland Hospital (Rochester, NY)
- **17350BR** **Title:** Risk Leader Specialist **Department/Cost Center:** 776 - Quality Assurance **Job Description:** Highland Hospital is seeking an experienced ... Risk Leader Specialist to work part time (24 hours a week)....skills for risk assessment and trend analysis. Experience with grievance management systems and professional practice evaluation processes. Demonstrated… more
- New York State Civil Service (Syracuse, NY)
- …People With Developmental Disabilities, Office for Title Human Resources Specialist 1/Trainee 1/2 Occupational Category Administrative or General Management Salary ... State NY Zip Code 13212 Duties Description Under the direction of a Human Resources Specialist 2, the Human Resources Specialist 1 will perform and support a… more
- CUNY (New York, NY)
- Legal Specialist - Paralegal **POSITION DETAILS** The CUNY School of Medicine (SoM) located in the heart of Harlem, New York, is the only medical school in the City ... diversity of our student body. The SoM is currently seeking a Legal Specialist . The successful candidate will provide administrative and legal research support to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Depending on the specific tasks assigned, the Medical Services Coordination Specialist provides administrative support for any of the programs of Utilization ... generated to care management programs + Provides administrative support to the grievance and appeals process within the + Medical Services department Level III… more
- Molina Healthcare (Buffalo, NY)
- …appeals and grievances using support systems to determine appropriate appeals and grievance outcomes. * Requests and reviews medical records, notes, and/or detailed ... bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. * Meets claims production standards set by the… more
- Cushman & Wakefield (New York, NY)
- …policies for applicable staff (ie: Section 504/Fair Housing Procedure, Tenant Grievance Policy, Employee Grievance Procedure, Performance Improvement Plans, ... and Recertification (Recertification Director, Rental Manager, Rental Assistant, Quality Assurance Specialist , etc.,) + Attend trainings and seminars by HCR, MRI,… more
- University of Rochester (Rochester, NY)
- …employee questions, concerns and grievances. **ESSENTIAL FUNCTIONS** + Arranges grievance hearings and conferences between Union and University representatives as ... information in support of analysis using HRIS data, personnel files, and grievance data. + Composes and types of non-routine confidential correspondence. + Serves… more
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