• Clinical Appeals Supervisor

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate implementation of the clinical appeal process ... the activities and serves as a resource for associates within the Clinical Appeals and Analysis unit. **ESSENTIAL FUNCTIONS:** + Provides direct supervision for… more
    CareFirst (03/04/25)
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  • Supervisor , Appeals and Grievances…

    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, ... net required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical...position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical… more
    LA Care Health Plan (12/20/24)
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  • Supervisor , Appeals Grievance…

    Centene Corporation (Sacramento, CA)
    …with claims, appeals , and grievance strongly preferred.** **Position Purpose:** The Supervisor of Appeals & Grievances is accountable for the recruitment, ... recruiting, hiring, promotion, and performance evaluation tasks and counsels non- clinical Grievance and Appeals staff. + Orients...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
    Centene Corporation (03/14/25)
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  • Supervisor , Grievance & Appeals

    Centene Corporation (Tallahassee, FL)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... **Two (2) years of leadership, hospital claims, and provider post service appeals experience strongly preferred.** **Position Purpose:** Supervise the day to day… more
    Centene Corporation (03/12/25)
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  • Grievances & Appeals Representative

    Humana (Santa Fe, NM)
    …any of the above you may be a great fit for Humana's Grievances & Appeals Representative 3 role! **What we need your help with:** + Managing client medical denials ... by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted....Training and Nesting you will be assigned to another supervisor and Team Lead within the department** **Work Hours**… more
    Humana (03/13/25)
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  • OCYF Lead- Supervisor Clinical

    State of Colorado (Denver, CO)
    OCYF Lead- Supervisor Clinical Review Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4858125) Apply  OCYF Lead- Supervisor ... + Child and Youth Medicaid System Analyst IV - Hybrid (https://www.governmentjobs.com/careers/colorado/jobs/4857855/child-and-youth-medicaid-system-analyst-iv- hybrid ) + OCYF Clinical more
    State of Colorado (03/15/25)
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  • Psychologist I - Forensic Evaluator - Statewide…

    State of Colorado (Denver, CO)
    …I - Forensic Evaluator - Statewide ( Hybrid ) **$14,000 Sign On Incentive** Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4840836)  ... PSYCHOLOGIST I - Forensic Evaluator - Statewide ( Hybrid ) **$14,000 Sign On Incentive** Salary $95,340.00 Annually Location Denver, CO Job Type Full Time Job Number… more
    State of Colorado (03/06/25)
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  • OCYF Clinical Review Specialist

    State of Colorado (Denver, CO)
    …Analyst IV - Hybrid (https://www.governmentjobs.com/careers/colorado/jobs/4857855/child-and-youth-medicaid-system-analyst-iv- hybrid ) + OCYF Lead- Supervisor ... Specialist Description of Job Please Note: This position has hybrid work arrangements, employees are expected to report to...with high acuity needs. This position reports to the Clinical Review Team Supervisor . This team works… more
    State of Colorado (03/15/25)
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  • Patient Account Specialist II (Accounts…

    Tufts Medicine (Lawrence, MA)
    …health insurers, follows up with health insurers about submitted claims, and performs appeals for non- clinical denials, etc. An organizational related support or ... 4:30 PM or 8:30 AM to 5:00 PM. **Location:** Hybrid working model. Required to work onsite once per...focuses on support of daily business activities (eg, technical, clinical , non- clinical ) operating in a "hands on"… more
    Tufts Medicine (03/10/25)
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  • Appeal Analyst Pharmacy Medicare

    Corewell Health (Grand Rapids, MI)
    …Ensure favorable decisions are properly effectuated. Assist the Lead and/or Supervisor in coordinating activities and in the development/collection of materials ... State and Federal decisions are properly implemented. Assist the Lead, Supervisor and/or Manager in coordinating activities and in the development/collection of… more
    Corewell Health (03/14/25)
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