Appeals and Grievances Specialist

About the RoleThe Appeals and Grievances team at Blue Shield of California is seeking a highly skilled and experienced professional to join our team as an Appeals and Grievances Representative, Advanced. In this role, you will be responsible for handling incoming appeals and grievances, researching and resolving complex issues, and providing exceptional...

Your RoleThe Commercial Appeals and Grievances team conducts thorough investigations concerning the details and situations surrounding member complaints, appeals, and grievances. The Operations Specialist - Experienced will report to a Supervisor within the Commercial Appeals and Grievances department. In this capacity, you will collaborate with the...

Job OverviewYour RoleThe Commercial Appeals and Grievances team is dedicated to conducting thorough investigations concerning member complaints, appeals, and grievances. The Experienced Operations Specialist in this area will report directly to a Supervisor within the Commercial Appeals and Grievances team. In this capacity, you will collaborate with the...

Job OverviewYour RoleThe Commercial Appeals and Grievances team is dedicated to conducting thorough investigations concerning member complaints, appeals, and grievances. The Experienced Operations Specialist will report directly to a Supervisor within the Commercial Appeals and Grievances department. In this capacity, you will collaborate with the leadership...

Your RoleThe Provider Dispute Resolution Team at Blue Shield of CA is seeking an Advanced Provider Dispute Resolution Coordinator to research, review, and resolve high-level/high-priority provider grievances, appeals, and complaints. This role requires a subject matter expert in guidelines and documentation, participating in special projects, and identifying...

About the RoleThe Provider Dispute Resolution Team at Blue Shield of CA is seeking an Advanced Provider Dispute Resolution Coordinator to join our team. As a key member of our team, you will be responsible for researching, reviewing, and resolving high-level/high-priority provider grievances, appeals, and complaints.Key ResponsibilitiesProcess provider...

Position OverviewThe Commercial Appeals and Grievances team is dedicated to conducting thorough investigations regarding member complaints, appeals, and grievances.The Operations Specialist in this area will report directly to a Supervisor within the Commercial Appeals and Grievances team.Key ResponsibilitiesIn this position, you will collaborate with the...

About the RoleThe Commercial Appeals & Grievances department at Blue Shield of California performs comprehensive research related to the facts and circumstances of member complaints, appeals, and grievances.The Commercial Appeals & Grievances Supervisor will report to the Commercial Appeals & Grievances Senior Manager.Key ResponsibilitiesBe responsible for...

About the RoleBlue Shield of California is seeking a highly skilled and experienced Operations Manager to join our Appeals and Grievances team. As a key member of our leadership team, you will be responsible for leading a team of professionals in resolving member concerns through a regulated process.Key ResponsibilitiesLead a team of professionals in...

{"title": "Operations Manager", "content": "Job SummaryBlue Shield of California is seeking an experienced Operations Manager to join our Appeals and Grievances team. In this role, you will be responsible for leading a team of professionals in resolving member concerns through a regulated process.Key ResponsibilitiesLead a team of professionals in resolving...

Job SummaryBlue Shield of California is seeking a highly skilled Manager of Operations to lead our Appeals and Grievances team. As a key member of our organization, you will be responsible for resolving member concerns through a regulated process.About the RoleProvide leadership and support to your team, interacting with members and specialty clients.Develop...

Job SummaryBlue Shield of California is seeking a highly skilled Business Operations Lead to join our team. As a key member of our Appeals and Grievances team, you will be responsible for resolving member concerns through a regulated process.About the RoleProvide leadership and support to your team, interacting with members and specialty clients.Develop and...

About the RoleWe are seeking a highly skilled and experienced Operations Manager to join our team at Blue Shield of California. As a key member of our Appeals and Grievances team, you will play a critical role in resolving member concerns through a regulated process.Key ResponsibilitiesLead a team of professionals in planning, cost management, and methods to...

Job SummaryBlue Shield of California is seeking a highly skilled Manager of Operations to join our Appeals and Grievances team. As a key member of our leadership team, you will be responsible for resolving member concerns through a regulated process, ensuring accurate, timely, and compliant responses.Key ResponsibilitiesProvide leadership and support to your...

Job SummaryBlue Shield of California is seeking a highly skilled Manager of Operations to join our Appeals and Grievances team. As a key member of our leadership team, you will be responsible for resolving member concerns through a regulated process, ensuring accurate, timely, and compliant responses.Key ResponsibilitiesProvide leadership and support to your...

About the RoleThe Manager of Operations will play a crucial role in leading the Appeals and Grievances team at Blue Shield of California. This team is responsible for resolving member concerns through a regulated process, ensuring accurate, timely, and compliant responses to each concern.The successful candidate will report to the Senior Manager of...

Your RoleThe Appeals and Grievances division is dedicated to addressing our members' concerns through a structured process that ensures each issue is handled accurately, promptly, and in compliance with regulations. The Senior Operations Manager will report directly to the Senior Director of Operations. In this capacity, you will lead and support your team...

About the RoleThe Manager of Operations will report to the Senior Manager of Operations and be responsible for leading a team in resolving member concerns through a regulated process. This includes accurately, timely, and compliantly addressing each concern. The successful candidate will provide leadership and support to their team, interact with members and...

About the RoleThe Care Management team at Blue Shield of California plays a vital role in supporting the organization's mission to provide high-quality healthcare services to its members. As a Senior Care Manager, you will be responsible for ensuring that services are provided based on standardized procedures, including coordination of care with specialists,...

Your RoleThe Federal Employee Program (FEP) Care Management team is dedicated to executing integrated case management (CM) and disease management (DM) activities. This role requires the application of clinical judgment and independent analysis through collaboration with members and their care teams, including a multidisciplinary group and the member's...