- UpvoteDownvoteShare Job
- Suggest Revision
Seek to resolve differences in accordance with the scriptural patterns summarized in the Staff Manual policy on Fair Treatment as well as the Grievance and Appeals Procedure. The job of the social media manager is to manage the social media accounts (mainlyInstagram) of the Center for Calling and Career.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Interface with Grievance and Appeals, Claims, Enrollment, IT, Network Management, Pharmacy, Authorizations, and other internal departments to provide Service Excellence to our members.
RemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Review decision letters regarding appeals and grievance for accuracy prior to delivery. Provide technical interpretations and guidance on Human Resource Management matters such as employee relations, labor relations, payroll and benefits, classification, staffing, and recruitment.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Commercial Grievance and Appeals knowledge is highly preferred. Experience and knowledge with PEGA NextGen is highly preferred. This position will work a hybrid model (remote and office.
ExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Makes medical necessity determinations for grievance and appeals appropriate for their specialty. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Review Level of Care for iCare members including follow-up consultation with Grievance and Appeals or Enrollment/Eligibility/Fiscal staff. The Screener is responsible for screening members within the iCare Family Care Partnership service areas, as well as participate in all iCare and WI State LTCFS required compliance and quality assurance activities.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Claims Supervisor is responsible for the day-to-day management of the Senior Analyst claims team, who handle a variety of tasks including, but not limited to, Customer emails, Correspondences, Grievance and Appeals, HRA, Balance Bills and Transplants, enabling the team to deliver exceptional service to our customers.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
- Suggest Revision
May also engage in grievance and appeals reviews. Become a part of our caring community and help us put health first. Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Recommend to Program/Clinical Director action on student grievance and appeals. CSN employs only U.S. citizens and aliens authorized to work in the U.S. CSN does not sponsor aliens applying for faculty, professional staff, or management positions (H-1B Visas) in the absence of exceptional circumstances as defined by the USCIS.
Part-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Clinical Operations Associate Medical Director responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. Preferred Experiences, Capabilities, and Skills:3 years post residency or fellowship clinical expereince strongly preferred.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope.
ExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Under general supervision of the Grievance and Appeals Manager performs a variety of complex, responsible and confidential duties requiring a thorough knowledge of organizational procedures and precedents perform routine clerical, administrative duties in support of the Grievance and Appeal Department.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
We are seeking a talented Grievance & Appeals Specialist who will be responsible for responding to written/verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with NCQA, CMS, State, and other regulations.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Description Clinical Operations Associate Medical Director Carelon Medical Benefit Management Interventional Pain Benefit Review Location : This position will work a hybrid model (remote and office.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Research and resolve grievance and appeals for the commercial line of business, utilizing a higher level of adjudicator expertise, clinical interpretation and decision making.
ExpandApply NowActive JobUpdated 4 days ago
grievance appeals and jobs
FEATURED BLOG POSTS
Learn How to Respond to an Interview Request With Templates
Job interviews are an inevitable part of any job search. So, handling them well is key to building a fulfilling career. Regardless of whether you’re looking at a more junior role or strive for a role as a business executive, you need to maintain your professionalism every step of the way in order to stay in the game.
How to Write an Address Correctly: Explained with Examples
It's hard to imagine a scenario where a text or phone call just won't do these days. With communication at our fingertips, you may think learning how to write an address is a superfluous skill. But it's a skill that will come in handy when you need to fill out healthcare forms, ship a package, order food delivery, or even apply for new jobs.
5 Common Interview Mistakes
Everyone's interview process is unique in some form or fashion. Like most, your interview process is crafted so you can get the most information out of your candidates to increase hiring confidence and make the right hiring decisions. However, there are often small problems in interview processes that could ultimately affect the success of hiring decisions.
How to Write a Job Description?
It might be tempting to overlook the importance of a well-written job description. After all, if you’ve posted job ads before and ended up with tons of resumes in hand, it’s easy to assume that this will always be the case, regardless of how your job ad reads. But, in reality, you really can’t take getting an influx of resumes for granted.
How to Get a W2 From Previous Employers
When tax time rolls around, the last thing you want to worry about is having to track down a W-2 from your former employer. Many times you won’t have to because the IRS requires companies to send these forms to all current and former employees who have earned more than $600 in the last year. Unfortunately, there are employers who don’t do what they’re supposed to. There are even times where something else may happen that prevents the W-2 from getting where it’s supposed to go.
How to Ask Someone to be a Reference + Email Templates
One part of the job-hunting process that frequently gets overlooked is putting together a list of good references. Most of the time we focus on creating the perfect resume, writing an awesome cover letter, and getting our hands on letters of recommendation. We think about what outfit we’ll wear to the job interview, how we’ll answer those tricky questions, and what our career plan looks like. But, in fact, having multiple references lined up who will speak favorably about you to a potential employer is critical to landing a job. This aspect of job searching really can’t be ignored.
Job Rejection Email Response with Examples
Glassdoor estimates that, on average, there are about 250 applicants for every job vacancy out there. If you’ve ever applied for a job, the odds are that you’ve received the dreaded job rejection email.