Find work in the United States.
A simpler way to find your next job.
Added
Grievance & Appeals Representative
Humana Pharmacy Solutions, Inc.
The Grievances & Appeals Representative 2 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal…
Added
Supervisory Veterans Service Representative (AVSCM)
Veterans Benefits Administration
The Supervisory Veterans Service Representative (AVSCM) manages Veterans Service Center (VSC) division operations through a staff of personnel responsible for providing information, advice,…
Added
HUMAN RESOURCES MANAGER
The GEO Group
Monitors unemployment claims, assists with appeals and may attend hearings as the Human Resources representative.
Added
HUMAN RESOURCES MANAGER
The GEO Group
Monitors unemployment claims, assists with appeals, and may attend hearings as the Human Resources representative.
Added
Direct Appointment Dean of Instruction
Yuba Community College District
EXAMPLES OF TYPICAL JOB FUNCTIONS (Illustrative Only) The duties recorded below are representative of the duties of the class and are not intended to cover all the duties performed by…
Added
Utilization Management Services Representative I (Multiple Openings!)
Capital District Physicians Health Plan Inc
Added
MGR, REGL HUMAN RESOURCES - EASTERN
The GEO Group
Monitors unemployment claims, assists with appeals and may attend hearings as the Human Resources representative.
Added
Utilization Management Services Representative I (Multiple Openings!)
Excellus BlueCross BlueShield
Assists with coordinating Grievance and Appeals requests.
Added
Executive Director, Elementary
Santa Barbara USD
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential responsibilities and functions of the job and are not…
Added
Grievance & Appeals Case Analyst
Partnership HealthPlan of California
Represents Partnership in the Grievance & Appeals Resolution process. Responsible for reviewing,investigating, and resolving assigned member grievance and appeal cases ranging from low…
Added
Healthplan Representative
Kaiser Permanente
Responsible for communicating with members or their authorized representative(s), regarding the Health Plans response and grievance/complaint process.
Added
Customer Service, New Business Operations- Hybrid Franklin, TN
CVS Health
Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system.
Added
Utilization Management Services Representative I (Multiple Openings!)
Lifetime Workforce Solutions, LLC
Assists with coordinating Grievance and Appeals requests.
Added
Customer Service, New Business Operations- Hybrid Franklin, TN
Aetna Resources, LLC
Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system.
Added
CDOC Telehealth Physician II - Colorado Springs
State of Colorado
…consultations, medical reporting, medical co-signature and inmate grievance requirements are completed in accordance with DOC Administrative Regulations, policies and procedures, clinical…
Added
CDOC Corrections Case Manager I (Buena Vista)
State of Colorado
Maintain a multidisciplinary network of effective communication, providing opportunities for offenders to receive feedback, crisis intervention, and grievance resolution;
Added
Employee Labor Relations Consultant - Barnesville/Harrison/Wheeling Satellite
BARNS Barnesville Hospital
…conditions, disciplinary actions, and employee and applicant appeals and grievances. According to circumstances, provides appropriate guidance to hospital management and…
Added
Grievances and Appeals Representative
Humana Pharmacy Solutions, Inc.
The Grievances & Appeals Representative 3 manages members and provider PART B denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if a…
Added
Registered Nurse - Utilization Management I
CareOregon, Inc.
Healthcare utilization management experience in the functional focus area (Appeals and Grievance, Benefits Review or Benefit Management)
Added
Population Health & Care Coordination Aide
South Florida Community Care Network LLC
Provide support to the Grievance and Appeals team by assisting enrollees in navigating complaints, grievances, and appeals processes.
Added
Member Services Representative I - Bilingual Cantonese / Job Req 788843328
ALAMEDA ALLIANCE FOR HEALTH
…also responsible for maintaining accurate and complete inquiry/grievance records in the electronic database. Maintains compliance with DMHC regulatory requirements and DHCS contractual…
Added
SCA Appeals Representative I
Elevance Health
The SCA Appeals Representative I is responsible for reviewing, analyzing, and processing non-complex pre and post service grievances and appeals requests from customer types (i.e., member,…
Added
CDOC (Health Professional VI) - Health Service Administrator - (STERLING)
State of Colorado
Ensures staff compliance with the offender grievance process, offender co-pay, electronic data entry, and information systems requirements;
Added
Government Programs Customer Service Representative
Delta Dental
…agencies or client contracts. - Informs and assists callers with grievance and the claims appeals processes, as necessary - Clearly, accurately and thoroughly documents information in the…
Added
CPW PROFESSIONAL ENGINEER III / Capital Development Program Manager (Denver, CO)
State of Colorado
…plans, appraisals, hiring, promotion, corrective actions, and grievance resolutions. Directs work allocation, monitors technical deliverables for correctness and engineering soundness, and…