Supervisor, Customer Solution Center Appeals and Grievances

Job SummaryThe Appeals and Grievances Supervisor is responsible for overseeing the Appeals and Grievances department, ensuring thorough investigations are completed according to company policies and procedures. This role involves leading and directing the team's work, monitoring research, negotiation, and resolution of all types of appeals and grievances....

Job SummaryThe Appeals and Grievances Supervisor is a critical role within the Customer Solution Center, responsible for leading a team that handles appeals and grievances in a healthcare setting. This position requires strong leadership and analytical skills, with the ability to manage large volumes of data and navigate complex regulatory requirements.Key...

About the RoleThe Appeals and Grievances Supervisor is a key member of the Customer Solution Center team, responsible for overseeing the intake, research, resolution, tracking, trending, and reporting of appeals and grievances within the department.This role involves leading and directing the team's work by monitoring the research, negotiation, and...

Job SummaryThe Appeals and Grievances Supervisor is responsible for overseeing the Appeals and Grievances department, ensuring thorough investigations are completed according to company policies and procedures. This role involves leading and directing the team's work, monitoring research, negotiation, and resolution of all types of appeals and grievances.Key...

Job SummaryThe Customer Solution Center Appeals and Grievances Specialist II will receive, investigate and resolve member and provider complaints and appeals exercising strong independent judgment.This position will provide resolution of complaints in compliance with regulatory requirements, including CMS, DHCS, DMHC, MRMIB and NCQA standards.This position...

Job SummaryThe Customer Solution Center Appeals and Grievances Specialist II will receive, investigate and resolve member and provider complaints and appeals exercising strong independent judgment.This position will provide resolution of complaints in compliance with regulatory requirements, including CMS, DHCS, DMHC, MRMIB and NCQA standards.This position...

Job OverviewThe Grievance and Appeals Operations Manager is tasked with overseeing and guiding the team responsible for the reception, investigation, resolution, monitoring, analysis, and reporting within the Grievances and Appeals division. This role is pivotal in steering the efforts of the department by ensuring comprehensive investigations are conducted...

Job SummaryWe are seeking a highly skilled and experienced Manager II Grievance/Appeals to join our team at Elevance Health. As a key member of our Claims Support department, you will be responsible for managing the grievance and appeals process, ensuring compliance with regulatory requirements, and providing exceptional service to our clients and...

Job DescriptionAt Elevance Health, we are seeking a highly skilled Manager II Grievance/Appeals to join our team. This role will be responsible for managing the grievances and appeals departmental units, ensuring compliance with regulatory requirements, and providing exceptional service to our clients and providers.Key Responsibilities:Maintain and...

Job SummaryThe Customer Service Representative II plays a critical role in ensuring that member and provider complaints and appeals are resolved in a timely and fair manner. This position requires strong independent judgment, conflict resolution, and persuasion skills to resolve complex issues.Key ResponsibilitiesInvestigate and resolve administrative...

Job SummaryThe Customer Solution Center Appeals and Grievances Specialist II will receive, investigate and resolve member and provider complaints and appeals exercising strong independent judgment. This position will provide resolution of complaints in compliance with regulatory requirements.Key ResponsibilitiesIdentify, investigate, and resolve...

Job SummaryThe Customer Solution Center Appeals and Grievances Specialist II will be responsible for receiving, investigating, and resolving member and provider complaints and appeals in a timely and professional manner. This role requires strong analytical and problem-solving skills, as well as the ability to exercise independent judgment and make sound...

Job SummaryThe Customer Solution Center Appeals and Grievances Specialist II plays a critical role in ensuring the highest level of customer satisfaction by resolving member and provider complaints and appeals in a timely and efficient manner. This position requires strong analytical and problem-solving skills, as well as excellent communication and...

Job SummaryElevance Health is seeking a highly skilled Manager II Grievance/Appeals to join our team. As a key member of our Claims Support department, you will be responsible for managing the grievance and appeals process, ensuring compliance with regulatory requirements, and providing exceptional service to our clients and providers.Key...

{"title": "Operations Manager", "content": "About the RoleThe Appeals and Grievances team at Blue Shield of CA is responsible for resolving member concerns through a regulated process. As an Operations Manager, you will provide leadership and support to your team, interacting with members, specialty clients, and regulators. You will develop and present...

Job Title: Nurse SupervisorWestwood Healthcare & Wellness Center is seeking a skilled Nurse Supervisor to join our team.Job Summary:The Nurse Supervisor will be responsible for overseeing the nursing department, ensuring the highest quality of care for our patients. This role requires strong leadership and communication skills, as well as the ability to work...

{"Job Title": "RN Supervisor Registered Nurse", "Job Description": "Job SummaryWestwood Healthcare & Wellness Center is seeking a skilled RN Supervisor Registered Nurse to join our team. As a licensed professional nurse, you will be responsible for assisting the planning, organizing, developing, and directing of nursing service to ensure the highest degree...

Job OverviewThe Regulatory Compliance Analyst II plays a crucial role in ensuring adherence to regulatory requirements by formulating auditing methodologies, overseeing the compliance framework, executing focused audits, and offering suggestions for remedial actions. In this capacity, you will be responsible for developing a corrective action strategy for...

{"title": "Operations Manager", "content": "About the RoleThe Appeals and Grievances team at Blue Shield of CA is responsible for resolving member concerns through a regulated process. As an Operations Manager, you will provide leadership and support to your team, interact with members and specialty clients, and work directly with our regulator to develop...

Job Title: RN Supervisor Registered NurseWestwood Healthcare & Wellness Center is seeking a skilled RN Supervisor Registered Nurse to join our team. As a licensed professional nurse, you will be directly under the supervision of the Director of Nursing Services.Job Summary:The RN Supervisor Registered Nurse is responsible for assisting in the planning,...