- VNS Health (Manhattan, NY)
- …criteria. + Enters data and assists with compiling reports and analysis on the grievance and appeals process. + Participates in special projects and performs ... experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required +… more
- Commonwealth Care Alliance (Boston, MA)
- …to appeal and grievances. **What You'll Be Doing:** - Processing of Grievances & Appeals . - Responsible for the progress of grievance and appeal intervention and ... strict deadlines. - When necessary collaborate with care teams, clinical staff, family members, and other involved in providing...dental, reporting, and member services. - Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal ... and grievance process that meets state, federal, accreditation and other...of clinical nursing and medical practices, the Clinical Appeals Specialist will review… more
- BayCare Health System (Clearwater, FL)
- …be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Grievance Specialist -Health Plan **Location** Clearwater:Park Place | ... ensuring adherence to regulatory requirements. + Triage, plan, and execute intake of Appeals and Grievance submissions. + Keeping track of deadlines, ensuring… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides… more
- LA Care Health Plan (Los Angeles, CA)
- Cultural and Linguistic Services Specialist II Job Category: Clinical Department: Cultural & Linguistic Location: Los Angeles, CA, US, 90017 Position Type: Full ... purpose. Job Summary The Cultural and Linguistic Services (C&L) Specialist II is responsible for overseeing and ensuring the...grievance and complaint process by working closely with Appeals and Grievances (A&G) and language vendors on case… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …determined within appropriate timeframes. This position will serve as a liaison to the Grievance and Appeals Department for Medicare Advantage appeals . The ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews,...plan, ACO, IPA, or provider group or 3 years clinical nursing experience Preferred: N/A **License(s)** Required: TX LVN… more
- State of Colorado (Denver, CO)
- …Number CAA P/T Physician 9/2024 Department Department of Corrections Division Clinical and Correctional Services Opening Date 09/18/2024 Closing Date 10/2/2024 4:00 ... on-call assessment, diagnosis, and treatment of inmates in one or more prison clinical settings. Physicians are responsible for, but not limited to, the following: +… more