• Grievances and Appeals 3

    CenterWell (Raleigh, NC)
    **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
    CenterWell (10/03/25)
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  • Grievances & Appeals Representative

    Humana (San Juan, PR)
    **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
    Humana (09/19/25)
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  • Registered Nurse (RN) Manager, Appeals…

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: ... required to achieve that purpose. Job Summary The Manager, Appeals & Grievances (A&G) & General Operations...years of clinical acute care experience with at least 3 years of experience with health care grievance and/or… more
    LA Care Health Plan (09/09/25)
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  • Director, Appeals and Grievances…

    Sanford Health (Sioux Falls, SD)
    … appeals and grievances , regulatory oversight, or health policy. At least 3 years in a leadership role managing appeals , grievances , or regulatory ... appeals and grievance resolution. Lead and manage the end-to-end appeals and grievances process for all product lines, ensuring compliance with federal and… more
    Sanford Health (09/29/25)
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  • Supervisor, Customer Solution Center…

    LA Care Health Plan (Los Angeles, CA)
    …Degree Experience Required: At least 3 years in a healthcare setting in Grievances and Appeals , Compliance, Claims or Call Center. At least 2 years of ... Supervisor, Customer Solution Center Appeals and Grievances (Temporary) Job Category: Management/Executive Department: CSC Appeals & Grievances Location:… more
    LA Care Health Plan (09/16/25)
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  • Coord Appeals & Grievances

    AmeriHealth Caritas (Newark, DE)
    …more about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances , this position is responsible for the ... management + Monitors to ensure that all problems with appeals / grievances presented by plan members/participants are resolved...experience in a Managed Care environment + 1 to 3 years' experience in grievance/ appeals environment required… more
    AmeriHealth Caritas (09/03/25)
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  • Manager II Grievance & Appeals

    Elevance Health (Columbus, OH)
    …an accommodation is granted as required by law._ The **Manager II Grievance & Appeals ** responsible for management oversight of grievances and appeals ... departmental units to investigate, resolve, and respond to grievances and appeals , manages inventory and production...degree and a minimum of 5+ years grievance & appeals experience and a minimum of 3 … more
    Elevance Health (10/02/25)
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  • Grievance/ Appeals Analyst I

    Elevance Health (Norfolk, VA)
    …HS diploma or GED and a minimum of 3 years experience working in grievances and appeals , claims, or customer service; or any combination of education and ... reviews, analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types (ie member, provider, regulatory and… more
    Elevance Health (09/19/25)
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  • Appeals And Grievance Specialist

    Area Agency On Aging 1-b (Southfield, MI)
    …Appeals and Grievance Specialist is responsible for managing and resolving appeals and grievances in accordance with contractual, regulatory, and ... and Grievance Specialist is responsible for managing and resolving appeals and grievances in accordance with contractual,...to Advanced. OUR INDUSTRY-LEADING BENEFITS CONSISTS OF: Choice of 3 excellent next to zero cost Medical Plans including… more
    Area Agency On Aging 1-b (09/24/25)
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  • Mgr II Grievance/ Appeals -Medical Coding

    Elevance Health (Atlanta, GA)
    …not eligible for employment based sponsorship. **Responsible for management oversight of grievances and appeals departmental units to investigate, resolve, and ... respond to grievances and appeals , manages inventory and production...degree and a minimum of 5+ years grievance & appeals experience and a minimum of 3 … more
    Elevance Health (09/24/25)
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