- BayCare Health System (Clearwater, FL)
- …1 day in office required Equal Opportunity Employer Veterans/Disabled **Position** Grievance Specialist -Health Plan **Location** Clearwater:Park Place | Business ... records. Triage, plan, and execute intake of Appeals and Grievance submissions. + Keeping track of deadlines, ensuring all...and contribute to the development of best practices for grievance and appeal resolution. + Adhere to HIPAA requirements,… more
- AmeriHealth Caritas (Philadelphia, PA)
- …. **This position is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible for the full life cycle of ... assigned member and/or provider appeals and grievance cases. Working under general supervision, this role conducts case intake, investigation, and documentation to… more
- Healthfirst (FL)
- …+ 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
- LA Care Health Plan (Los Angeles, CA)
- …all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist .; submit all Grievances and Appeals response letters to ... Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative and technical functions of the… more
- State of Indiana (Pendleton, IN)
- …youths. Role Overview: This role serves as the facility's policy coordinator, grievance specialist , PREA coordinator, legal liaison, security coordinator, and ... public information officer. It ensures compliance with IDOC policies, ACA accreditation standards, PREA requirements, and regulatory agency rules while communicating policy updates and maintaining accurate electronic records. The position oversees youth… more
- University of Southern California (Los Angeles, CA)
- The Patient Safety & Resolution Specialist plays a key role in responding to patient concerns, adverse events, and care-quality issues across Keck Medicine of USC. ... Finance within the Office of Integrated Risk Management, the Specialist conducts thorough and impartial investigations; facilitates clear, empathetic communication… more
- Tufts Medicine (Boston, MA)
- …research breakthroughs to life. **Job Overview** The Senior Employee & Labor Relations Specialist serves as a trusted subject matter expert and strategic partner to ... role may delegate and oversee the work of the Employee & Labor Relations Specialist . This position requires deep knowledge of both employment and labor laws (eg,… more
- Howard University Hospital (Washington, DC)
- …outcomes. Howard University Hospital seeks to hire a Labor & Employee Relations Specialist who will embrace our rich and historic tradition of excellence. If you ... $67,482 - $107,971 based on experience Labor and Employee Relations Specialist : Investigates and research labor relations matters, employee and union complaints,… more
- GE Aerospace (Evendale, OH)
- …Manager and the Human Resources team at the Evendale campus. The HR/UR Specialist will own the contractual internal movements for our hourly population in Evendale ... the UAW and IAM populations. + Has oversight for grievance process administration, ensuring data is up to date...administration, ensuring data is up to date in the grievance tracking system and that physical files contain all… 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