- Centene Corporation (Austin, TX)
- …workplace flexibility. POSITION IS REMOTE THIS TEAM PROCESSES APPEALS ONLY Appeals Experience HIGHLY Preferred **Position Purpose:** The Supervisor of ... accountable for the recruitment, hiring, promotion, counseling, and daily supervision of Grievance and Appeals Specialists and administrative support as they… more
- Point32Health (TX)
- …here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- Centene Corporation (Austin, TX)
- … appeals and grievances from a clinical perspective. Ensure that the clinical Appeals and Grievance department processes all cases in accordance with policies ... perspective on workplace flexibility. POSITION IS REMOTE THIS TEAM PROCESSES APPEALS ONLY Appeals Experience HIGHLY Preferred **Position Purpose:** Supervise… more
- University of Utah Health (Salt Lake City, UT)
- …EO/AA_ + Supervise the day-to-day activities of staff who process member and provider Grievance and Appeals . + Monitor and set goals for staff workloads. + ... operated in accordance with applicable law. + Demonstrated understanding of insurance appeals and grievance processes. + Demonstrated experience in improving… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Medicare Appeals Analyst Supervisor is responsible for managing, supporting, and oversight of the Appeals and Grievance team; this ... and strategic plans to achieve expected performance. The Medicare Appeals Analyst Supervisor provide leadership to direct...are being met. Essential Functions + Ensure that the Appeals & Grievance department processes all … more
- LA Care Health Plan (Los Angeles, CA)
- …Grievances is responsible for assisting with the development of a successful and cohesive Appeals and Grievance unit, with a high level of productivity to ... and/or exceed member satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring work, providing feedback on… 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
- Commonwealth Care Alliance (Boston, MA)
- …& Responsibilities:** + Conduct monthly case review of a random sample of appeals and grievance cases against previously developed scorecard and Federal and ... 011540 CCA- Appeals & Grievances **Position Summary:** Appeals ...State Regulations. Complete individual summary scorecards for Supervisor feedback. + Track monthly scores on spreadsheet and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member… more
- The Cigna Group (Nashville, TN)
- Delivers specific delegated tasks assigned by a supervisor in the Utilization Management job family. Completes day to day Utilization Review tasks without immediate ... Requirements include, but not limited to:** + Must have experience in Medicare Appeals , Utilization Case Management or Compliance in Medicare Part C + Ability to… more