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It is a fast-paced extremely deadline-driven department charged with processing all Termination of Tenancy (including various Tenancy related Applications to Re-open Defaults, Removal of Permanent Exclusion and Blatch), Grievance, Applicant Appeals and Trespass cases and Guardian Ad Litem (GAL) matters.
$46,231 - $69,583Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting the Appeal and Grievances Compliance, Training and QA Manager to develop a successful and cohesive unit with a high level of productivity and focus on implementing, executing, tracking, and assessing targeted and random audits for non-clinical grievance and appeal case documentation.
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Meets performance measurement goals for Grievance and Appeals Resolution Services. Evaluates case details, proposes recommendations, or makes decisions as applicable; ensures organization decision is implemented according to the Grievance and Appeals policies and case resolution.
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Coordinates with other departments, e.g. Care Management, Legal Affairs, Grievance and Appeals, Compliance, Membership Eligibility Unit, Quality as needed. Knowledge of Medicaid and/or Medicare regulations required Working Knowledge of UAS-NY.
$85,000 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Demonstrated successful conflict management skills and negotiation of "win-win" solutions required Working knowledge of Microsoft Excel, Power-Point, and Word required Knowledge of Medicaid and/or Medicare regulations required Working Knowledge of UAS-NY.
$85,000 - $106,300 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Under general supervision, the Attorney will conduct prosecution of disciplinary proceedings pursuant to Civil Service Law 75 including internal DOT disciplinary proceedings, OATH trials, grievance proceedings and arbitrations, Civil Service Commission disciplinary appeals and related civil litigation.
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Makes medical necessity determinations for grievance and appeals appropriate for their specialty. Job Description :Clinical Operations Associate Medical DirectorCarelon Medical Benefit ManagementInterventional Pain Benefit ReviewLocation: This position will work a hybrid model (remote and office.
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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 11 days ago - UpvoteDownvoteShare Job
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Senior Grievance and Appeals Specialist. Knowledge of Medicare/Medicaid Grievance and appeals process. Handle inbound calls related to grievances, bills, appeals and access related issues.
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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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