• Health Plan Grievance

    University of Utah Health (Salt Lake City, UT)
    …1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is ... day-to-day activities of staff who process member and provider Grievance and Appeals . + Monitor and set...and Clinics represents our clinical operations for the larger health system. **Responsibilities** + Lead the Appeals /Grievances… more
    University of Utah Health (01/28/25)
    - Related Jobs
  • Manager, Grievance and Appeals , RN

    VNS Health (Manhattan, NY)
    …the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our grievance ... the intake, investigation and resolution of member grievances and appeals for one of the following VNS Health...and select journal reading. Identifies and recommends changes to plan grievance and appeal operations accordingly. +… more
    VNS Health (12/04/24)
    - Related Jobs
  • Medical Director - Regulated Medicare…

    CVS Health (Salem, OR)
    …**Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly Preferred ... Bring your heart to CVS Health . Every one of us at CVS ...this Medical Director role are related to Regulated Medicare Appeals : * Direct daily work on part C … more
    CVS Health (02/01/25)
    - Related Jobs
  • Specialist, Grievance and Appeals

    VNS Health (Manhattan, NY)
    …analyzes and solves problems. Consults with the member, family, providers and health plan departments as necessary. Identifies and communicates key points ... Entities and Quality Improvement Organizations. + Collaborates with professionals, health plan departments such as Claims and...and assists with compiling reports and analysis on the grievance and appeals process. For Fair Hearings:… more
    VNS Health (01/23/25)
    - Related Jobs
  • Appeals and Grievance Analyst

    Point32Health (TX)
    …we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage ... **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member ...efficiency and compliance. + Must be able to organize, plan and implement the functions of Member Appeals more
    Point32Health (01/08/25)
    - Related Jobs
  • Grievance / Appeals Analyst I

    Elevance Health (Las Vegas, NV)
    **Title: Grievance / Appeals Analyst I** **Location:** This position will work a remote model. Ideal candidates will live within 50 miles of one of our PulsePoint ... locations. The ** Grievance / Appeals Analyst I** is an entry level...$33.58/hr. Locations: California In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
    Elevance Health (01/31/25)
    - Related Jobs
  • Grievance / Appeals Analyst I

    Elevance Health (Wallingford, CT)
    **Title: Grievance / Appeals Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... one of our PulsePoint locations. The ** Grievance / Appeals Analyst I** is an entry level...skills, and analytical skills. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
    Elevance Health (01/28/25)
    - Related Jobs
  • Appeals and Grievance Specialist…

    Baylor Scott & White Health (Temple, TX)
    **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... complaints, appeals and grievance cases for products for...benefits package includes the following + Immediate eligibility for health and welfare benefits + 401(k) savings plan more
    Baylor Scott & White Health (01/28/25)
    - Related Jobs
  • Appeals and Grievance Coord

    Baylor Scott & White Health (Temple, TX)
    **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written ... complaints, grievances and requests for appeals that involve complex matters submitted by Members and...benefits package includes the following + Immediate eligibility for health and welfare benefits + 401(k) savings plan more
    Baylor Scott & White Health (02/05/25)
    - Related Jobs
  • Grievance & Appeals Nurse

    TEKsystems (Rancho Cucamonga, CA)
    Grievance & Appeals Nurse (Hybrid -...to change and may be subject to specific elections, plan , or program terms. If eligible, the benefits available ... (LVN) looking to make an impact? We're hiring a Grievance & Appeals Nurse to ensure that...& vision* Critical Illness, Accident, and Hospital* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available* Life… more
    TEKsystems (02/05/25)
    - Related Jobs