Grievance and Appeals Coordinator

Job SummaryThe Appeals and Grievances Supervisor is responsible for leading and directing the work of the Appeals & Grievances department. This includes monitoring research, negotiation, and resolution of appeals and grievances to ensure thorough investigations are completed in accordance with company policies and procedures.Key ResponsibilitiesDirect...

Appeals and Grievances SupervisorOur client in Downtown Los Angeles is seeking an Appeals and Grievances Supervisor to join their team in a mostly remote role with occasional on-site work.Key Responsibilities:Supervise and support a team handling appeals and grievances, ensuring thorough investigations and timely resolutions.Lead and direct team work,...

Job Title: Appeals and Grievances SupervisorThe Appeals and Grievances Supervisor plays a critical role in ensuring the efficient resolution of appeals and grievances within the Customer Solution Center. This position involves leading a team of professionals who handle the intake, research, resolution, tracking, and reporting of appeals and grievances.Key...

Job SummaryThe Appeals and Grievances Supervisor is responsible for leading a team that handles appeals and grievances in a healthcare setting. This role involves supervising and supporting team members, monitoring research and resolution of appeals and grievances, and ensuring thorough investigations are completed according to company policies and...

Job Title: Appeals and Grievances SupervisorThe Appeals and Grievances Supervisor is a critical role within the Customer Solution Center, responsible for leading and directing the team that handles appeals and grievances. This position involves monitoring research, negotiation, and resolution of appeals and grievances, ensuring thorough investigations are...

Job Title: Appeals and Grievances SupervisorThe Appeals and Grievances Supervisor plays a critical role in ensuring the efficient and effective resolution of appeals and grievances within the healthcare industry. This position requires a strong leader who can supervise and support a team of professionals in handling complex cases, analyzing data, 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 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 SummaryWe are seeking a highly skilled Appeals and Grievances Specialist I to join our team at Insight Global. As a key member of our Customer Solution Center, you will play a critical role in receiving, investigating, and resolving member and provider complaints and appeals.Key ResponsibilitiesInvestigate and resolve less complex appeals and grievances...

Job Title: Customer Solutions Center Appeals and Grievances Training Specialist IIAt CCG Business Solutions, LLC, we are seeking a highly skilled and experienced Training Specialist II to join our team. As a key member of our Customer Solutions Center Appeals and Grievances team, you will be responsible for providing ongoing training on the core processing...

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...

Job OverviewPositions available for a Quality Assurance Nurse and a Compliance Specialist. QUALITY ASSURANCE NURSEOBJECTIVE:The Quality Assurance Nurse plays a crucial role in collaboration with the Medical Director, the VP of Clinical Policy, and the Quality Management Committee to develop, implement, and enhance the Quality Management Program. This...

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 SummaryWe are seeking a highly motivated and experienced Union Representative/Organizer to join our team at Service Employees International Union. The successful candidate will be responsible for leading strategic campaigns to promote the interests of our members and advance the goals of our union.Key ResponsibilitiesDevelop and implement strategic plans...

About the RoleWe are seeking a highly skilled Operations Manager to join our team at Blue Shield of California. As a key member of our Appeals and Grievances team, you will be responsible for leading a team of professionals in resolving member concerns through a regulated process.Key ResponsibilitiesProvide leadership and support to your team, ensuring...

Care Management Nurse Job DescriptionAt New Century Health Plan, we are seeking a highly skilled Care Management Nurse to join our team. As a Care Management Nurse, you will play a vital role in coordinating care for our Medicare Advantage members.Key Responsibilities:Develop and implement individualized care plans based on Health Risk Assessment.Facilitate...

Care Management Nurse Job DescriptionAt New Century Health Plan, we are seeking a highly skilled Care Management Nurse to join our team. As a Care Management Nurse, you will play a vital role in coordinating care for our Medicare Advantage members, focusing on improving health outcomes and streamlining the care journey for members with complex healthcare...

Job SummaryWe are seeking a highly motivated and experienced Union Representative/Organizer to join our team at Service Employees International Union. The successful candidate will be responsible for leading strategic campaigns to build power for workers and advance the union's vision.Key ResponsibilitiesIdentify, recruit, train, and develop worksite leaders...

Job SummaryWe are seeking a highly motivated and experienced Union Representative/Organizer to join our team at SEIU Local 0. The successful candidate will be responsible for leading strategic campaigns to build power for workers and advance the union's vision for a strong and just labor movement.Key ResponsibilitiesIdentify, recruit, train, and develop...

Job SummaryAs a Merchandise Coordinator at HomeGoods, you will play a key role in maintaining a culture of honesty and integrity while ensuring the sales floor is accurately stocked and visually appealing.Key ResponsibilitiesProcess and prepare merchandise for the sales floor in accordance with company procedures and standards.Maintain and uphold the...