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
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
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
Become a part of our caring community The Grievances and Appeals Representative 4 role in the Internal Review Team is responsible for managing appeal denials, by reviewing clinical documentation, determining whether further action is needed, and validating
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
Salary Range: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (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
Become a part of our caring community Become a valued member of Humanas Internal Review Team as a Grievances & Appeals Representative 2, where you will play a critical role in addressing client concerns and denials. You
Specialist, Members Appeals & Grievances Mon - Fri 9am -6pm EST, 8am - 5pm CST, 7am -4pm MST, 6am -3pm PST JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider
OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration. That’s why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists
Your Role The Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post-service or claim denial. The Appeals and Grievances RN Senior will report to the Manager
At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success. Were committed to helping our employees grow through thoughtful development opportunities, meaningful
Fairfield, CA or Redding, CA (100% Onsite) $36.00/hour Monday-Friday | 8:00 AM - 5:00 PM Position Overview Partnership HealthPlan of California is seeking a Grievance & Appeals Case Analyst to investigate, manage, and resolve member grievances and appeals.
URGENTLY HIRING! MUST HAVE: Grievance & Appeals experience . 100% Remote (CA, AZ, NV or TX) $24/hr | 5-Month Contract . MUST HAVE: 2+ years of Grievance & Appeals experience Healthcare, Health Plan, or Managed Care experience Medicare