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Provide information about override guidelines, benefit plan restrictions, prior authorization requirements, grievance and appeal processes, and other PBM functions as specified by health plan sponsors in online CS Notes.
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Rick's employees are also protected against retaliation if they engage in a protected activity, whistleblowing, or the exercise of any appeal or grievance right provided by law. Rick Engineering Company (RICK) is seeking a confident, and experienced Project Engineer / Manager to join our Public Works Division at our Phoenix, AZ office.
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Explains and obtains signatures on hospital legal forms i.e. Conditions of Admission, Financial Agreement, Advance Directive, Hospital Grievance policy. Assists in obtaining or validating pre-certification, referrals, and authorizations.
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Research claims appeals and grievances using support systems to determine appeal and grievance outcomes. Health claims processing background, including coordination of benefits, subrogation, and eligibility criteria.
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As a Project Engineer / Manager in Phoenix, AZ, you will have an opportunity to work with a multi-disciplinary team on meaningful, landmark projects in the Phoenix region. Candidate’s technical experience to include a combination of the following: public agencies, capital improvement projects, design-build projects, pipeline projects, transportation projects, water resources projects, preliminary engineering design studies (incorporating assessment and consideration of site constraints and potential regulatory issues.
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Participates in quality improvement program that will assure that patients receive quality care in the office and from other providers of health care service, using peer review, medical records audits, grievance and other mechanisms as appropriate.
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Participates as a management representative in the grievance/arbitration procedure, union contract discussion and union contract negotiations. Equal Opportunity Employer Statement Salt River Project (SRP) recognizes diversity and inclusion as key drivers of innovation and growth, and seeks to attract a diverse employee base that reflects our community.
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Positions in the Employee Relations Division manage multiple projects for HR activities including hiring and selection, labor relations, investigations, discipline and grievance administrative hearings, employee transactions and position control, payroll, employee development, FMLA/ADA and leave administration, HR strategy and policy development, and workforce planning.
$84,468.8 - $137,592 a yearFull-timeExpandApply NowActive JobUpdated Yesterday
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