Grievance Resolution Specialist
2 weeks ago
AlohaCare is seeking a highly skilled Grievance Coordinator to join our Appeals and Grievances team. As a key member of our team, you will be responsible for ensuring timely and compliant resolution of member and provider grievances and appeals.
Key Responsibilities- Review and research complaints, grievances, and appeals to ensure accurate and timely resolution.
- Coordinate with internal teams to ensure compliance with regulatory requirements and internal policies.
- Prepare and communicate written decisions to members and providers in a clear and concise manner.
- Maintain accurate records and logs of grievances and appeals, including tracking dispositions and timeliness of resolution.
- Participate in internal committee and interdisciplinary meetings to discuss recent activity and trends, and make recommendations for problem resolution and performance improvement.
- Associate's degree or equivalent combination of education and experience.
- 1-2 years of related work experience in healthcare or a related field.
- Excellent verbal and written communication skills, with the ability to communicate complex information in a clear and concise manner.
- Strong analytical and problem-solving skills, with the ability to work in a fast-paced environment.
- Ability to multitask and prioritize multiple projects and deadlines.
- Experience with utilizing multiple databases and software systems.
- Bachelor's degree in a related field.
- Knowledge of Medicaid, Hawaii QUEST Integration Program, and/or Medicare.
- Experience with grievance and appeal processing.
- Inside working conditions.
- No environmental hazards.
- Ability to conduct training and potentially use audiovisual presentations.
- Sedentary work, exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects.
$22.75 an hour.
AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans' status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.
-
Labor Relations Manager
1 week ago
Honolulu, Hawaii, United States HYATT Hotels Full timeJob Title: Labor Relations ManagerHyatt Regency Waikiki Beach Resort and Spa is seeking a Labor Relations Manager to manage the relationship between the hotel and the union. The successful candidate will act as a liaison between managers and union agents, focusing on dispute resolution and contract interpretation.Key Responsibilities:Oversee the daily...
-
Labor Relations Manager
3 weeks ago
Honolulu, Hawaii, United States Hyatt Regency Waikiki Beach Resort and Spa Full timeJob Title: Labor Relations ManagerThe Labor Relations Manager plays a critical role in maintaining a positive and productive relationship between the Hyatt Regency Waikiki Beach Resort and Spa and its unionized workforce. This position requires a strong understanding of labor laws and regulations, as well as excellent communication and negotiation skills.Key...
-
Workforce Management Specialist
1 month ago
Honolulu, Hawaii, United States U.S. Army Corps of Engineers Full timeAbout the PositionThe U.S. Army Corps of Engineers is seeking a highly skilled Workforce Management Specialist to join our team. As a key member of our Human Capital & Resource Management Career Field, you will play a critical role in advising District leadership on civilian and military workforce functions.ResponsibilitiesAdvise District leadership on...
-
Patient Relations Coordinator
2 weeks ago
Honolulu, Hawaii, United States Hawaii Pacific Health Full timeJob Title: Patient Relations CoordinatorAt Hawaii Pacific Health, we are seeking a highly skilled Patient Relations Coordinator to join our team. As a key member of our Risk Management department, you will play a critical role in promoting the health and safety of our patients, employees, physicians, and visitors.Key Responsibilities:Administer, manage, and...
-
Labor Relations Manager
2 weeks ago
Honolulu, Hawaii, United States Hyatt Regency Waikiki Beach Resort and Spa Full timeJob Title: Labor Relations ManagerThe Labor Relations Manager plays a critical role in maintaining a positive and productive work environment at the Hyatt Regency Waikiki Beach Resort and Spa. This position is responsible for managing the relationship between the hotel and the union, ensuring that all labor practices and agreements are in compliance with...
-
Quality Improvement Director
2 months ago
Honolulu, Hawaii, United States HMSA Full timeJob Description**Job Title:** Quality Improvement Director**Job Summary:** We are seeking a highly skilled Quality Improvement Director to lead our Quality Improvement program, ensuring compliance with accreditation, regulatory, and program requirements. The successful candidate will oversee project teams, provide guidance to subject matter experts, and...
-
Help Desk Specialist
3 weeks ago
Honolulu, Hawaii, United States Peraton Full timeJob Title: Help Desk SpecialistPeraton is seeking a highly skilled Help Desk Specialist to join our team. As a Help Desk Specialist, you will be responsible for providing technical support to users in a multi-user environment.Key Responsibilities:Provide technical support to users via phone, email, and in-personTroubleshoot and resolve technical issues with...
-
IT Support Specialist
3 weeks ago
Honolulu, Hawaii, United States TEKsystems Full timeJob DescriptionWe are seeking an IT Support Specialist to provide technical assistance with computer hardware and software.Key Responsibilities:Provide technical support to clients via phone, in person, or electronically.Recommend hardware and software improvements to enhance system performance.Track customer issues and resolutions to ensure timely and...
-
Help Desk Specialist
1 week ago
Honolulu, Hawaii, United States Lucayan Technology Full timeJob Summary:We are seeking a highly skilled Help Desk Specialist to join our team at Lucayan Technology Solutions LLC. The successful candidate will provide exceptional technical support to our customers, ensuring timely and effective resolution of IT issues.Key Responsibilities:Provide first-line support for IT issues via phone, email, or...
-
Security Operations Specialist
4 weeks ago
Honolulu, Hawaii, United States Zeus Fire and Security Full timeAbout UsZeus Fire and Security has established a reputation as a leading provider of life and safety solutions since 1962. With a strong presence in the industry, we offer a wide range of services and products to meet the needs of our customers.About the RoleThe Security Operations Specialist provides critical support to our customers by ensuring the...
-
Claims Operations Specialist
4 weeks ago
Honolulu, Hawaii, United States AlohaCare Full timeJob Title: Claims Operations SpecialistAlohaCare is seeking a highly skilled Claims Operations Specialist to join our team. As a Claims Operations Specialist, you will be responsible for managing business processes within the claims department, including Cost Share, Claims Recovery, and Claims Resolution.Key Responsibilities:Manage member cost share business...
-
Configuration Management Specialist
5 days ago
Honolulu, Hawaii, United States HMSA Full timeJob Summary: We are seeking a highly skilled Configuration Management Specialist to join our team at HMSA. The successful candidate will be responsible for establishing and executing consistent, repeatable software build and release processes, tracking and controlling the promotion of project software and hardware products and documentation between the...
-
Roving Compliance Specialist
1 week ago
Honolulu, Hawaii, United States Indigo Real Estate Full timeJob DescriptionRoving Compliance Specialist – Affordable HousingIndigo Real Estate is seeking an experienced Roving Compliance Specialist to support our affordable housing properties. The ideal candidate will have a strong background in tax credit compliance and excellent communication skills.Key Responsibilities:Assist sites with completing...
-
Mechanical Maintenance Specialist
1 week ago
Honolulu, Hawaii, United States Synagro Full timeJob SummaryAt Synagro, we're seeking a skilled Mechanical Maintenance Specialist to join our team. As a key member of our operations team, you'll be responsible for inspecting, maintaining, and controlling process equipment to ensure the safe and efficient operation of our wastewater treatment plant.Key ResponsibilitiesPerform preventative, corrective, and...
-
Insurance Sales Support Specialist
4 weeks ago
Honolulu, Hawaii, United States Comparion Insurance Agency Full timeJob Title: Insurance Sales Support SpecialistWe are seeking a highly skilled and motivated Insurance Sales Support Specialist to join our team at Comparion Insurance Agency. As a key member of our team, you will play a vital role in supporting our sales efforts and providing exceptional customer service to our clients.Responsibilities:Utilize consultative...
-
Chief Disciplinary Counsel
1 week ago
Honolulu, Hawaii, United States Inkinen Executive Search Full timeJob SummaryThe Chief Disciplinary Counsel is responsible for supervising the daily operations of the Office of Disciplinary Counsel, investigating ethics complaints, and prosecuting violations of the lawyers' ethics code. The successful candidate will also work with the Disciplinary Board on administrative matters and serve as a liaison to various entities...
-
Affordable Housing Compliance Specialist
4 days ago
Honolulu, Hawaii, United States Indigo Real Estate Full timeJob DescriptionAssistant Community Director/Compliance Specialist – Affordable HousingIndigo Real Estate is seeking an experienced Assistant Community Director/Compliance Specialist to join our team. This role is responsible for assisting the Community Director in planning, controlling, and directing the day-to-day operation of the property, and for...
-
IT Technical Solutions Specialist
2 days ago
Honolulu, Hawaii, United States TEKsystems Full timeWe are seeking a skilled IT Technical Solutions Specialist to join TEKsystems. This role involves resolving computer-related issues for clients, providing technical support for computer hardware and software, and recommending hardware and software improvements.Key Responsibilities:Provide technical assistance with computer hardware and softwareResolve issues...
-
Senior Product Control Specialist
3 days ago
Honolulu, Hawaii, United States Hawaii Medical Service Association Full timeJob SummaryWe are seeking a highly skilled Senior Product Control Specialist to join our team at Hawaii Medical Service Association. In this role, you will be responsible for coordinating and monitoring daily production schedules, tracking promotion requests, and assisting the systems and application development team in problem resolution.Key...
-
People Operations Specialist
4 days ago
Honolulu, Hawaii, United States Hawaii Community Foundation Full timeJob SummaryWe are seeking a highly skilled and experienced People Operations Specialist to join our team at the Hawaii Community Foundation. The successful candidate will play a crucial role in ensuring the effective implementation of our People Operations and Growth (POG) strategies and practices.Key ResponsibilitiesThrive and Grow and Employee Relations:...