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Serve as Hearing Officer for grievances and disciplinary appeals at the Step II level. Reporting directly to the Deputy Commissioner of Human Resources and Facilities Management (HRFM), the Director of Labor Relations will administer the Agency's labor relations program.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Professional experience with all steps of the grievance process, policy development, dispute resolution, as well as necessary familiarity with agency management and operations. Negotiate settlements in connection with grievance disputes and collective bargaining activities.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Can hold grievance hearings or appeals / Conduct investigation depending on nature of matter. Reporting into the Senior HR Business Partner, you will advise on the most complex processes, queries or issues to resolution, implementation of corporate policies, supporting Managers by addressing root causes of issues.
ExpandApply NowActive JobUpdated 15 days ago - UpvoteDownvoteShare Job
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Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc. Works with Quality Team, Health Plan Leadership team, VBS reporting team and other staff to manage contract performance and drives the development and implementation of value based contract relationships in support of business strategies.
$67,900 - $149,300 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Directs and coordinates day-to-day plan functions, including Reporting, Claims Administration, Encounter Data Quality, Grievance and Appeals, Information Technology and Systems, Enrollee Services, Provider Services, and Business Continuity Planning and Emergency Coordination.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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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. Complete clerical tasks assigned by the Chief Information Officer or the AVClassroom Specialist, including but not limited to reporting on inventory, updating schedules, etc.
(student)ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Departments reporting to this position include: Appeals and Grievance, Claims, Enrollment and Reconciliation, Premium Billing, Member Service and Experience, and Member Innovation.
$300,000 - $350,000 a yearFull-timeExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Ability to track and trend and create regulatory reporting. Education Preferred Experience Required: A minimum of 5 years experience in regulatory auditing (Appeals & Grievances, Call Center, Enrollment) in a healthcare environment required.
$88,854 a yearFull-timeExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Health plan core systems i.e. claims, membership, grievance and appeals. Business Intelligence skills i.e. analytics/reporting with POWER BI or other similar BI tool. Health plan core systems i.e. claims, membership, grievance and appeals.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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The Program Manager is a key member of the Medicare Advantage Claims, Configuration and Appeals and Grievance Operations team. Assists in planning, developing, implementing, and managing the Medicare Advantage Claims, Appeals and Grievance program requirements, operational initiatives and policies.
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Experience in Medicare Advantage Claims, Appeals & Grievances, program/project management. The incumbent reviews and analyzes key program, regulatory and operational performance indicators for the functional areas reporting to the Assistant Director, Medicare Advantage Operations and makes recommendations to the leadership team on strategies to improve performance.
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The Program Manager leads and manages key operational programs, initiatives and strategic projects that span across the functional teams of Claims, Configuration and Appeals and Grievances. Strong project management skills with the proven ability to deliver agreed objectives with timeframes, including experience in project outcome reporting utilizing industry standards.
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Along with the Assistant Director, Medicare Advantage Operations, the Program Manager is responsible for program management activities impacting the functional areas within the span of control of the Assistant Director including but not limited to initiation, planning, development, and monitoring of program implementations and day to day operations performance monitoring in order to ensure timeliness and compliance.
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Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks an accomplished Medicare Program Manager. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients businesses forward.
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Experience with Microsoft Office Suite (Excel, Word, and PowerPoint) and data visualization tools. Program Manager, Medicare Advantage Operations. Must have at least 3-4 years of managing projects or programs in a healthcare or ACO environment.
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