- 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
- Centene Corporation (Sacramento, CA)
- …**Must be located in California - occasional in-office meetings.** **Position Purpose:** The Supervisor of Appeals & Grievances is accountable for the ... + Performs recruiting, hiring, promotion, and performance evaluation tasks and counsels non- clinical Grievance and Appeals staff. + Orients and trains new… more
- State of Colorado (Pueblo, CO)
- Behavioral Health Supervisor - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4500403) Apply Behavioral Health Supervisor - Pueblo ... CAA HP V SCCF 9359 5/2024 Department Department of Corrections Division Clinical and Correctional Services Opening Date 05/16/2024 Closing Date 5/30/2024 4:00 PM… more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …issues. Resolves simple, informal complaints of employees and referring others, such as formal grievances and appeals to the supervisor or an appropriate ... (VALLHCS) is recruiting for a Lead Health Technician (Telehealth Clinical ) to provide an array of complex and specialized...direction relating to the telehealth program. Works with the supervisor to develop assignments for team members in order… more
- The Cigna Group (Bloomfield, CT)
- …, administrative and regulatory criteria for reviewing and making decisions on all non- clinical appeals and validating the accuracy of all received information + ... regarding Medicare appeals and related issues, implications and decisions. The Appeals Reviewer reports to the Supervisor /Manager of Appeals and… 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
- LA Care Health Plan (Los Angeles, CA)
- …closely with the Chief Operating Officer (COO) to allow for integration with claims, appeals and grievances , and our customer service center. The COE ensures ... Clinical Operations Executive Job Category: Management/Executive Department: Utilization...all HIPAA requirements. Actively identifies and makes recommendations to supervisor , ideas to improve the quality effectiveness and efficiency… more
- State of Colorado (Pueblo, CO)
- …Job This position provides operational and supervisory oversight of multi-disciplinary clinical services staff working at the San Carlos Correctional Facility. This ... position is an Administrative Supervisor with direct field of influence and accountability on...and completing performance evaluations per CDOC regulations, and resolves complaints/ grievances at the informal level; + Ensures staff compliance… more
- State of Colorado (Denver, CO)
- …+ 1 - 2 years + Less than a year 03 How many years of experience do you have as clinical supervisor ? + 2 or more years + 1 - 2 years + Less than a year 04 How ... and has primary oversight and supervision of the clinic. Job Duties: Clinical Management: Functions as the facility medical authority (RHA). Ensuring that health… 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
- CareOregon (Portland, OR)
- …following areas: Provider relations, managed care operations (eg, claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... Exemption Status Exempt Department Provider Relations Manager Title Provider Relations Supervisor Direct Reports n/a Requisition # 24285 Pay and Benefits Estimated… 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