Department Name: Banner Staffing Services-AZ Work Shift: Day Job Category:General Operations The future is full of possibilities. At Banner Plans & Networks, we’re changing the industry to reduce healthcare costs while keeping members in optimal health.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national
Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles
Exemption Status:United States of America (Non-Exempt) $19.11 - $24.65 - $30.19 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate
Anticipated End Date:2026-09-04 Position Title:Grievance and Appeals and State Fair Hearing Program, Business Change Manager Job Description: Grievance and Appeals and State Fair Hearing Program, Business Change Manager Location: Overland Park or Topeka, Kansas. This role is required
Category: Patient and Family Services Job Type: Full time Shift: Day - 08 Hour Location: Palo Alto, CA Req: LP_00018319-2653387 Employee Group: Exempt Benefits Eligible: Yes Remote Eligible: Yes Department: Navigation Services Scheduled Weekly Hours: 40
Salary Range: $47,840.00 (Min.) - $57,062.00 (Mid.) - $68,474.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles
Anticipated End Date:2026-10-26 Position Title:Grievance/Appeals Rep II Job Description: Grievance/Appeals Representative II Shift: Monday-Friday Location: Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to
Description Start 11/2 – HARD START Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.Education/Experience: High school diploma or equivalent. Associate’s degree preferred. 2+
JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers
About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and
General information: Timetable: 6-months consultancy contract trial period to then be re-evaluated for potential longer-term engagement. Deadline for applications: Priority will be given to applications submitted by 30 September 2026 (4pm Paris time). Travel: Future travel
Become a part of our caring community The Grievances & Appeals Representative 3 (Part Time 24 hours a week) manages members and provider denials and concerns through conducting a comprehensive analytic review of clinical documentation to determine
Your Role The Appeals and Grievances teams receive, document, investigate, refer, and coordinates grievances, appeals and complaints. The Appeals and Grievances Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming
Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a
Hi, were Oscar. Were hiring a Specialist, Admin Complaints, Grievances & Appeals to join our CGA & MPCT team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus
Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Key Details: Must be authorized to work in the U.S. without the need for employment-based
Humana Inc. is seeking a Corporate Medical Director to provide clinical interpretation and independent judgment on service appropriateness, quality, and performance standards across Medicare, Medicaid, and Commercial lines. You will oversee reviews of grievance cases, act as
Sentara Health Plans in Virginia Beach region seeks a Director of Appeals and Grievance to plan, develop, and direct the department across Commercial, Medicaid, and Medicare lines of business. This role leads program development, strategic planning, and
GlobalHealth, Inc. is seeking a Nationally remote, clinical leader to direct Appeals & Grievances operations from Oklahoma City. The role oversees scheduling, resource balance, and the end-to-end appeals/grievances process, ensuring regulatory compliance and timely resolutions for members. The