Appeals and Grievances Team Lead

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...

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 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 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...

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 Title: Supervisor, Customer Solution Center Appeals and GrievancesJob Summary:The Supervisor, Customer Solution Center Appeals and Grievances is responsible for leading and directing the work of the Appeals and Grievances department. This includes monitoring the research, negotiation, and resolution of all types of appeals and grievances to ensure...

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 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 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...

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 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...

Exciting Opportunity at the California Department of JusticeThe California Department of Justice is seeking highly skilled attorneys to join the Appeals, Writs, and Trials Section of the Criminal Law Division in Los Angeles. As a member of this team, you will have the opportunity to work on complex felony criminal appeals, juvenile delinquency appeals, and...

{"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...

{"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...

Key Clinical Leadership RoleTake on a pivotal clinical leadership position within a dynamic healthcare organization. Drive the delivery of high-quality, cost-effective care for Medicare Advantage members. Elevate your expertise and contribute to the success of New Century Health Plan.Reporting to the Chief Medical OfficerYou will play a critical role in...

Key Clinical Leadership RoleTake on a pivotal clinical leadership position within a dynamic health organization, driving the delivery of high-quality, cost-effective care for Medicare Advantage members. Leverage your expertise to new heights at New Century Health Plan.Reporting to the Chief Medical OfficerYou will play a crucial role in leading clinical...

Job SummaryMother's Market is seeking a highly skilled and experienced Lead Cashier to join our team. As a key member of our store operations team, the Lead Cashier will be responsible for supervising cashiers, ensuring smooth store operations, and providing excellent customer service.Key ResponsibilitiesSupervise Cashiers: Oversee the daily activities of...