- CVS Health (Columbus, OH)
- …do** + Prepares and participates in external and internal audits. + Analyzes basic quality and completeness of the complaints and appeals documentation to ensure ... changes, as well as new training programs to drive quality results. + Assists in analyzing patterns, trends, and...years of External Audit Experience + 1+ years of Grievance and Appeals Experience **Education** + High… more
- Point32Health (Canton, MA)
- …direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- Elevance Health (Mason, OH)
- **Title: Grievance / Appeals Analyst I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... and ensures essential face-to-face onboarding and skill development. The ** Grievance / Appeals Analyst I** is an...and indemnity) related to clinical and non clinical services, quality of service, and quality of care… more
- CVS Health (Annapolis, MD)
- …ongoing provider in-services and provider education. + Participates, when requested, in Grievance and Appeals meetings, and/or assists with tracking and trending ... obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals , SIU, etc. Coordinates provider status information… more