- Elevance Health (Walnut Creek, CA)
- …**Costa Mesa** + **Palo Alto** + **Walnut Creek** The ** Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and appeals ... ** Manager II Grievance/ Appeals (RN)-California** **Location** :...departmental units to investigate, resolve, and respond to grievances and appeals , manages inventory and production… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN… more
- VNS Health (Manhattan, NY)
- …Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and grievances . + Ensures the accuracy and integrity of data ... of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the...Lead with Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long… more
- Elevance Health (KS)
- …**Grievance and Appeals Program Manager , Senior** will be responsible for managing Provider Grievances , Provider Appeals , and Provider State ... **Grievance and Appeals Program Manager , Senior** **Location:** Kansas....of process redesign strongly preferred. + Experience with Member Grievances , Appeals , administrative hearings, or other legal… more
- CVS Health (Richmond, VA)
- …and affordable. **Position Summary** Coordinate effective resolution of member and/or provider /practitioner appeals , complaints and grievances . Responsible ... management of staff to ensure effective resolution of member or provider /practitioner appeals , complaints and grievances for all products, which may… more
- Elevance Health (Atlanta, GA)
- …of a relevant Elevance Health location. **Responsible for management oversight of grievances and appeals departmental units to investigate, resolve, and respond ... to grievances and appeals , manages inventory and production...a resource for complex issues and interpretation of claims, provider contracts and data, eligibility, member contracts, benefits, clinical… more
- Elevance Health (Indianapolis, IN)
- …and processes non-complex pre service and post service grievances and appeals requests from customer types (ie member, provider , regulatory and third ... you will make an impact:** + Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory… more
- Elevance Health (Richmond, VA)
- …Department responsible to review, analyze and process pre service and post service grievances and appeals requests related to clinical and non clinical services, ... a quality manner. + May also be responsible to provide review and analysis of complex pre service and...and analysis of complex pre service and post service grievances and appeals requests from customer and… more
- Elevance Health (Norfolk, VA)
- …Department responsible to review, analyze and process pre service and post service grievances and appeals requests related to clinical and non clinical services, ... a quality manner. + May also be responsible to provide review and analysis of complex pre service and...and analysis of complex pre service and post service grievances and appeals requests from customer and… more
- CareFirst (Baltimore, MD)
- …educational and training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in the development and ... data and data related to the volume and complexity of the appeals and grievances submitted for resolution. **SUPERVISORY RESPONSIBILITY:** This position… more