Director of Appeals, Complaints, and Grievances

Job SummaryReporting to the Chief Medical Officer, the Director of Complaints, Grievances, and Appeals (CG&A) is responsible for directing CG&A operations, providing leadership and oversight for all lines of business. The Director will oversee key CG&A functions including the processing of member appeals, provider appeals, and payment disputes. In addition,...

Job Summary Reporting to the Chief Medical Officer, the Director of Complaints, Grievances, and Appeals (CG&A) is responsible for directing CG&A operations, providing leadership and oversight for all lines of business. The Director will oversee key CG&A functions including the processing of member appeals, provider appeals, and payment disputes. In...

Share This Page Job Details Requisition #: 639299 Location: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Leadership Schedule: Day Shift Job Summary Reporting to the Chief Medical Officer, the Director of Complaints, Grievances, and Appeals (CG&A) is responsible for directing CG&A operations, providing leadership and oversight for all lines of...

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3.2B business serving nearly 500,000 members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider sponsored health plans—backed by the clinical...

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3.2B business serving nearly 500,000 members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider sponsored health plans—backed by the clinical...

Benchmark Senior Living at Hanover is seeking an Executive Director! Joining the Benchmark Senior Living team means putting your passion to work. Our associates feel a sense of belonging with the care that they provide, empowered by the open and reliable team that surrounds them. Our diverse and skilled workforce takes immense pride in a shared commitment:...

Summary The Executive Director of Corporate Compliance and Regulatory Affairs (“Exec. Director”) at Johns Hopkins Health Plans (JHHP) reports to the Johns Hopkins Health System (JHHS) Chief Compliance Officer (and reports via a matrix relationship to the President of JHHP). The Exec. Director is responsible for the development, implementation,...

The Store Director is responsible for the day to day operations of the store. The Store Director has overall responsibility for the store operation and employees. The Store Director is responsible for making store level decisions on hiring, training, disciplinary action, and scheduling. The Company expects the Store Director will spend more than half their...

Job Description Utz Quality Foods is seeking a Director of Quality Assurance, Manufacturing. The Director of Quality Assurance, Manufacturing is responsible to organize, direct, control and evaluate the operations of the Quality Assurance and Food Safety (QAFS) systems across internal manufacturing facilities. Key ResponsibilitiesCoaches, develops, and...

Job DescriptionJob DescriptionPosition Type: Onsite, Part-Time (30 hours per week)The Development/Marketing Manager will play a crucial role in the growth and sustainability of our Home Health and Hospice Agency. This individual will be responsible for managing and executing the agency’s development and marketing strategies, focusing on building and...

Experience & Requirements: Graduate of an Accredited Nursing School required, and must be a masters level Registered Nurse, registered in Maryland. Current, unrestricted, non-probationary status license as a Registered Nurse in Maryland. Current Basic Life Support/CPR Certification at the Medical Professional Level with AED Training. American Heart...

OverviewHanover Inn, a prestigious and historic hotel known for its exceptional service and luxurious ambiance, is seeking an experienced Director of Food & Beverage. We are dedicated to providing unparalleled guest experiences and are looking for a dynamic leader to elevate our Food & Beverage operations. The objectives of the Director of Food & Beverage...

Requisition ID:197170 Posting Locations: Baltimore Click here to view a Day in the Life of our Teammates! Our Secret Ingredient is our Teammates. We offer great rewards , competitive pay , career advancement and growth opportunities . Full Time Teammates are also eligible for: Paid Training Paid Time Off plus paid holidays 401(k) with Company...

The Development/Marketing Manager will play a crucial role in the growth and sustainability of our Home Health and Hospice Agency. This individual will be responsible for managing and executing the agency’s development and marketing strategies, focusing on building and maintaining relationships with referral sources, writing grants, securing major gifts,...

Job DescriptionJob DescriptionYour New Organization: Looking to build your career in an exciting industry and a growing world class organization? They are the largest pest control company in the world, and they are looking to add a customer service representative to their team. They pride themselves on being a trusted partner to many of the world's...

Job DescriptionJob DescriptionYour New Organization:Looking to build your career in an exciting industry and a growing world class organization? They are the largest pest control company in the world, and they are looking to add a customer service representative to their team. They pride themselves on being a trusted partner to many of the world's...

Job Summary Under the direction of the Associate Chief Medical Officer, Quality & Transformation, this execution-focused position of the Quality Performance Director, for Medicaid, USFHP & EHP will support quality performance management for the Medicaid line of business, Priority Partners Managed Care organization (PPMCO), TRICARE Prime (USFHP), and...

Property About Us At Pyramid Global Hospitality, people come first. As a company that values its employees, Pyramid Global Hospitality is dedicated to creating a supportive and inclusive work environment that fosters diversity, growth, development, and wellbeing. Our commitment to a People First culture is reflected in our approach to employee development,...

The Development/Marketing Manager will play a crucial role in the growth and sustainability of our Home Health and Hospice Agency. This individual will be responsible for managing and executing the agency’s development and marketing strategies, focusing on building and maintaining relationships with referral sources, writing grants, securing major gifts,...

This position oversees the execution of Dartmouth College’s dining program and acts as a key leader in the strategic planning and management of 13 revenue centers with sales in excess of $34 million, 300+ associates, operations open 24 hours per day and a diverse menu offering. Provides direct management of a leadership team comprised of retail, catering,...