- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by ... trained skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced… more
- Evolent (Albany, NY)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator** **,** ** Appeals and Grievances ** at Evolent will serve as a point of contact ... for processing post determination reviews and appeals requests in accordance with departmental policies, regulatory requirements,...A high school diploma or GED is required. + 3 years of experience in an Intake Coordinator role… more
- Cognizant (Albany, NY)
- …any qualified applicant in the United States. **Job Summary:** We are seeking a dedicated Appeals & Grievance Specialist with 2 to 3 years of experience to join ... processes to improve efficiency and patient satisfaction. **Responsibilities:** Reviewing available Appeals & Grievances for the pending claims to verify… more
- Molina Healthcare (Albany, NY)
- …and delegated vendors must follow, and you keep complaint data synchronized across appeals & grievances , enrollment, claims, pharmacy, and quality functions. You ... 2. Workflow Integration - Embed CTM insights into downstream operations-Stars, appeals & grievances , enrollment, claims-so each team addresses systemic… more
- CUNY (Brooklyn, NY)
- …Rules); tracking student conduct reports; coordinating the student conduct process, grievances , and appeals . + Oversee the Faculty Student Disciplinary ... process, early intervention student support service process, the resolution of student grievances , appeals , and complaints, and the utilization of the Behavioral… more
- New York State Civil Service (Albany, NY)
- …these modernization efforts. Under the direction of the Human Resources Specialist 3 , (Labor Relations), the Human Resources Specialist Trainee 1 (Labor Relations), ... proper interpretation and administration of contract provisions relating to employee grievances or issues.* Assisting in the administration of the Department's… more
- City of New York (New York, NY)
- …United States law school as defined in the Rules of the New York Court of Appeals (Sections 520. 3 or 520.5) or admission to the New York State Bar. Additional ... related to labor law and employee discipline. The unit handles employee grievances , prosecutes disciplinary cases, and works with attorneys at the Mayor's Office… more
- City of New York (New York, NY)
- …issues including license and access issues, leasing, and eminent domain 3 ) procurement related issues including responsive and responsibility issues, bid protests, ... the Uniform Commercial Code ("UCC"); 10) assist division staff with procurement appeals and decision process, including draft opinions and presenting facts and… more
- City of New York (New York, NY)
- …United States law school as defined in the Rules of the New York Court of Appeals (Sections 520. 3 or 520.5) or admission to the New York State Bar. Additional ... for matters pending with the NYC Law Department and the NYC Comptroller's Office; 3 ) review agency responses to the public pursuant to the Freedom of Information Law… more
- MTA (New York, NY)
- …and participate in monthly conferences with union representatives to discuss contract grievances and employee discipline appeals ; perform analytical review of ... Authority is North America's largest transportation network, serving a population of 15. 3 million people across a 5,000-square-mile travel area surrounding New York… more
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