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Conduct the primary investigation and resolution of member appeals and grievances following established guidelines from: The Center for Medicaid and Medicare Services (CMS), MAXIMUS Federal Services, Department of Labor (DOL), Department of Insurance and Financial Services (DIFS), Michigan Department of Health and Human Services (MDHHS), National Committee for Quality Assurance (NCQA), Office of Personnel Management (OPM), MI Health Link, and Better Business Bureau (BBB.
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The Quality Supervisor must be a creative problem solver, proactive and steadfast in the identification and resolution of vehicle quality issues. Achieve timely completion of containment corrective actions (Performance action notices) Collaborate with Subject Matter Experts and utilize problem solving tools in day-to-day operations to drive issue resolution.
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Resolves or coordinates the resolution of complex technical issues on the assembly line and in the manufacturing process. As a leading global Tier 1 Automotive and Mobility Supplier, AAM (NYSE: AXL) designs, engineers and manufactures Driveline and Metal Forming technologies to support electric, hybrid and internal combustion vehicles.
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Resolution of data source Gaps and Exceptions required to determine reportability and ensure complete and accurate data used for quarterly TREAD EWR reporting purposes. Leading the Completeness & Accuracy analysis for the quarterly TREAD EWR reports (i.e., Death & Injury, Aggregate and Field Report Copies.
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Knowledgeable of crisis prevention, intervention and resolution techniques and is able to demonstrate and match techniques to particular circumstances ( SAMA, Mandt, CPI, de-escalation techniques, etc.
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Chieve timely completion of containment corrective actions (Performance action notices) Collaborate with Subject Matter Experts and utilize problem solving tools in day-to-day operations to drive issue resolution.
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Performs benefits administration, including claims resolution, change reporting, approving invoices for payment, and communicating benefit information to employees. The human resource generalist is responsible for performing HR-related duties professionally and working closely with the Client Care Coordinator and the Administrator to support designated geographic regions.
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Maintains the physical office location including processing of mail, supporting office maintenance and issue resolution, security, trash removal, etc. This role requires a mix of office management tasks such as maintaining office supplies, support of building maintenance tasks, administrative duties such as expense report reviews, new hire on and off boarding support, and operations support working on special projects under the direction of the VP of Operations.
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Strong interpersonal skills, focusing on conflict resolution and openness to others' ideas. Resolves issues independently aiming for first call resolution whenever possible. With a strong insurtech focus, we embrace a broad and innovative approach to serving agents and clients alike.
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Assist with the design, development and problem resolution of new and existing software, SIL models, HIL Models, test scripts and components for powertrain, and chassis products. Assist with the design, development and problem resolution of new and existing software, SIL models, HIL Models, test scripts and components for powertrain, and chassis products.
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Handle employee relations matters, including conflict resolution, investigations, and disciplinary actions. The HR Generalist will be responsible for performing a wide range of HR duties, including recruitment, employee relations, benefits administration, performance management, and HR compliance.
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Is a subject matter expert in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes. The Pharmacy Benefits Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization, and pharmacy benefit inquiries from members/patients, physicians, pharmacies, and other internal and external individuals.
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This position is considered as essential personnel for a public health emergency response per the State's Emergency Management Act 390 and Macomb County emergency Management Resolution. Complies with P.A. 390, as amended, known as the State’s Emergency Management Act and the County’s Emergency Management resolution as well as all related plans, policies and procedures covered by those statutes.
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The objective is to produce high quality visibility through customer reports, to provide timely responses and case resolution for customers, and to provide exceptional freight operations support.
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Demonstrates CML (Creating Member Loyalty)/SLS (Sales Leadership Strategies) skills and provides a positive role model for others including: active listening to seek understanding of members'/team members' needs, issues in need of resolution, etc.
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resolution job Title: master Company: Colsh Consultants in Sterling Heights, MI
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