- VNS Health (Manhattan, NY)
- …navigating the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the daily operations ... of our grievance and appeals processes. You will play a crucial role in...Relations, Claims, Medical Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and… more
- Elevance Health (Norfolk, VA)
- ** Manager II Grievance / Appeals (RN)- Claims Support** **Location** : This position will work in a hybrid model (remote and office). Ideal candidates will ... one of our PulsePoint locations. Expected Work Hours: Monday-Friday; 8AM-5PM EST The ** Manager II Grievance / Appeals ** is responsible for management oversight… more
- Centene Corporation (Indianapolis, IN)
- …CANDIDATE MUST RESIDE IN INDIANA **Position Purpose:** Ensure appropriate processing of member grievance appeals , provider appeals , or request for a State ... of contact with the State. Manage the day to day responsibilities of the Grievance & Appeals Coordinators. + Ensure that the Grievance and Appeals … more
- Centene Corporation (Austin, TX)
- …initial and ongoing training in necessary skills and knowledge base and will assist Manager of Grievance and Appeals to establish and maintain procedures ... accountable for the recruitment, hiring, promotion, counseling, and daily supervision of Grievance and Appeals Specialists and administrative support as they… more
- Elevance Health (Richmond, VA)
- **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...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- 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...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- The Cigna Group (Nashville, TN)
- …related issues, implications and decisions. The Case Management Analyst reports to the Supervisor/ Manager of Appeals and will coordinate and perform all appeal ... Cigna Medicare Part C Appeals Reviewer: Appeals Processing Analyst We...Director. + Determine whether additional pre service, appeal or grievance reviews are required and/or whether additional appeal rights… more
- Point32Health (MA)
- …members, partners, colleagues and communities. **Job Summary** Under the direction of the A&G Manager , the Appeals & Grievances QA Auditor audits the quality of ... letters and keyed entries from the Grievance and Appeals systems. Checks cases built by other associates to ensure highest level of quality and timeliness.… more
- Elevance Health (Walnut Creek, CA)
- **Nurse Appeals - Licensed RN Nurse** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the state of ... locations. **Shift:** Monday to Friday from 8:00am-5:00pm **PST** The **Nurse Appeals ** is responsible for investigating and processing medical necessity appeals… more
- HCA Healthcare (Rochester, NH)
- …set us apart from any other healthcare provider. We are seeking aCase Manager to join our healthcare family. **Benefits** Frisbie Memorial Hospital, offers a total ... - and empowers their passion for patient care. Apply today for our Case Manager opportunity. **Job Summary and Qualifications** The Case Manager is responsible… more