- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
- State of Colorado (Arapahoe County, CO)
- Clinical Team Leader - Marvin W Foote Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4523588) Apply Clinical Team ... evaluations if credentialed; Neuropsychological screenings and evaluations if credentialed; clinical consultation with Behavioral Health Specialists, Client Managers and… more
- State of Colorado (Pueblo, CO)
- Occupational Therapist Supervisor - Therapist IV Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4506134) Apply Occupational Therapist ... Supervisor - Therapist IV Salary $98,000.00 Annually Location Pueblo,...care in groups or individualized treatment sessions + Provide clinical and administrative supervision to OT staff providing OT… more
- Veterans Affairs, Veterans Health Administration (Montgomery, AL)
- …issues; Resolving simple, informal complaints of employees and referring others, such as formal grievances and appeals , to the supervisor or an appropriate ... Summary The Lead Health Technician (Telehealth Clinical ) provides direct leadership to multiple Telehealth ... staff participating in telehealth programs Working with the supervisor to develop assignments for team members in order… more
- Hackensack Meridian Health (Hackensack, NJ)
- …functions and performance improvement activities for the case managers. The Supervisor Case Management is accountable for the department's designated staff caseload ... case management process, including LOS, throughput, patient flow and denials and appeals follow up. i. Responsible for staff productivity and ongoing education. j.… more
- The Cigna Group (Nashville, TN)
- …related issues, implications and decisions. The Case Management Analyst reports to the Supervisor /Manager of Appeals and will coordinate and perform all appeal ... in Medicare Part C + Ability to differentiate different types of requests Appeals , Grievances , coverage determination and Organization Determinations in order to… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Care Management Coordinator Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... net required to achieve that purpose. Job Summary The Supervisor of Care Management Coordinator is responsible for direct...in Managed Care preferably in Customer Service, Care Management, Appeals and Grievances and/or Claims. Participated in… more
- CVS Health (Columbus, OH)
- …but not limited to customer service, claim, provider services, complaints, grievances , and appeals , implementation, and/or plan sponsor operations. Executes ... service solution for large plan sponsors. Our embedded and customer-dedicated service, clinical , and rising risk pods allow maximization of inbound and outbound… more
- Commonwealth Care Alliance (Worcester, MA)
- …coordinate with relevant department(s) within CCA, or contracted IPAs + Assist members with appeals and grievances status, coordinate with Appeals and ... Exercised:** No **What You'll Be Doing:** + Answer incoming member calls for non- clinical issues and questions with the goal of first call resolution with each… more
- State of Colorado (Denver, CO)
- …youth, in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional or ... program. + Recommends any modifications of the program to supervisory and/or clinical staff. Facilitates and monitors cleanup of pod and rooms, inspects, according… more
- State of Colorado (Denver, CO)
- …of accuracy in order to meet legal requirements. This position serves as clinical administrative support to multi-disciplinary staff. Duties are as follows, but not ... health care information; + Execute, copies and distributes the release of clinical information from health records; + Request clinical information from… more
- State of Colorado (Grand Junction, CO)
- …youth, in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional or ... with the written program. Recommend any modifications of program to supervisory and/or clinical staff. Facilitate and monitor the cleanup of living units and rooms,… more
- State of Colorado (Colorado Springs, CO)
- …youth, in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional or ... written program. Recommends any modifications of the program to supervisory and/or clinical staff. Facilitates and monitors cleanup of pod and rooms, inspects,… more
- CareOregon (Portland, OR)
- …following areas: Provider relations, managed care operations (eg, claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... Status Exempt Requisition # 24293 Direct Reports n/a Manager Title Provider Relations Supervisor Pay & Benefits Estimated hiring range $ 70,310 - $85,075 / year,… more
- Beth Israel Lahey Health (Westwood, MA)
- …information. Escalates calls to pharmacists for clinical inquiries and escalates grievances to supervisor . 7. Maintains new and existing patient profiles and ... Support health care providers with required prior authorization and required appeals . Manage all mail/delivery of Rx orders including addressing problems/issues with… more
- Intermountain Health (Murray, UT)
- …in member tracking tool using correct and accurate notation + Assists members with grievances and appeals process + Required to meet all department standards ... lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class team… more
- CareOregon (Medford, OR)
- …the following areas: Provider relations, managed care operations (eg claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... # 24280 Direct Reports n/a Manager Title Provider Relations Supervisor Pay & Benefits Estimated hiring range $ 56,730...partner in the resolution of issues. + Participate in Clinical Advisory Panel (CAP) meetings. Contract Initiation + Identify… more