- Evolent (Nashville, TN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Appeals and Grievances ** at Evolent is responsible for reviewing ... prior authorization experience. This role is distinct from other coordinator positions in that it is dedicated to case...required. + Minimum of 3 years' experience in an Appeals and Grievances role or comparable administrative… more
- AmeriHealth Caritas (Philadelphia, PA)
- …more about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances , this position is responsible for the ... complaints/issues to management + Monitors to ensure that all problems with appeals / grievances presented by plan members/participants are resolved in accordance… more
- Banner Health (AZ)
- **Department Name:** Grievances & Appeals **Work Shift:** Day **Job Category:** General Operations **Estimated Pay Range:** $20.01 - $30.01 / hour, based on ... our innovation to employment settings by including remote and hybrid opportunities. ** Appeals and Grievances Management** + Review, research, investigate, and… more
- Centene Corporation (Raleigh, NC)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and appeals + Maintain files on… more
- CVS Health (IL)
- …Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs ... state regulations. **What you will do** + Reviews, and processes appeals and grievances filed by patients. + Assists with adherence to regulatory requirements,… more
- CVS Health (Sacramento, CA)
- …quality measures, with respect to letter content and turn-around time for appeals , complaints and grievances handling. -Independently researches and translates ... PST Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may… more
- TEKsystems (Long Beach, CA)
- …structure and maintains current and additional information as it relates to Grievances and Appeals services. Utilizes department desktop procedures, workflows, ... High School Diploma, Required 2 years of experience within grievances and appeals in a healthcare setting Experience Level Expert Level #westpriority25… more
- CoreCivic (Estancia, NM)
- …a responsibility to better the public good. We are currently seeking a **Grievance Coordinator ** who has a passion for providing the highest quality care in an ... making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures that both informal and… more
- Elevance Health (KS)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Concierge Coordinator ** **Location: This position is fully remote but...is granted as required by law._** The **LTSS Concierge Coordinator ** is responsible for supporting the LTSS Coordinator… more
- Elevance Health (Columbus, OH)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Concierge Coordinator (Case Manager)** **Hiring statewide across Ohio** **This...and supports, and psychosocial needs. The **LTSS Transition Concierge Coordinator ** is responsible for supporting the LTSS Transition … more