Sr Manager, Grievance - Orange, CA

We are seeking an experienced Sr Manager to lead our Grievance & Appeals Resolution Services department. · The Team You'll JoinWe are a mission-driven community-based organization that serves member health with excellence and dignity. · If you are ready to advance your career whi ...

+ Sr Manager Grievance & Appeals Resolution Services + CalOptima health organization seeks Sr Manager for Grievance & Appeals team to shape future of healthcare + This position has been approved to be Partial Telework If telework is approved you are required to work within State ...

The Senior Manager Appeals Grievance Center Quality Excellence leads operational performance regulatory compliance service quality continuous improvement across all appeals grievance functions. · The Senior Manager plans implements systems procedures maximize operating efficiency ...

The Senior Manager will drive operational performance, regulatory compliance, service quality, and continuous improvement across all appeals and grievance functions. · ...

+Job summary · The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity respecting the value and needs of each person. · +ResponsibilitiesCoordinates and participates in case discussions with operational exper ...

The Appeals & Grievance Coordinator is responsible for the day-to-day functions of tracking and trending all grievances, appeals, and complaints received within the Member Services Department. · Will appropriately acknowledge the receipt of all grievance/appeals, · Responsible fo ...

The Appeals & Grievance Coordinator is responsible for the day to day functions of the tracking and trending of all grievances appeals and complaints received within the Member Services Department. · Will appropriately acknowledge the receipt of all grievance/appeals CTM (Complai ...

The Grievance and Appeals Nurse Specialist manages medical appeals and state hearing reviews across all lines of business, · handling both expedited and standard requests.This role ensures compliance with regulations,policies,and procedures while preparing case narratives and pos ...

A Medicare Plans Coordinator will assist in carrying out department responsibilities. · Participates in a mission-driven culture of high-quality performance. · ...

<p ALIGNMENT HEALTH IS BREAKING THE MOLD IN CONVENTIONAL HEALTH CARE COMMITTED TO SERVING SENIORS AND THOSE WHO NEED IT MOST THE CHRONICALLY ILL AND FRAGILE IT TAKES AN ENTIRE TEAM OF PASSIONATE AND CARING PEOPLE UNITED IN OUR MISSION TO PUT THE SENIOR FIRST WE HAVE BUILT A TEAM ...

We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. · ...

Auditor (GARS) role at CalOptima Health involves auditing provider disputes and grievance activities to ensure compliance with policies and regulatory requirements. · ...

The Team You'll Join: · We are a mission driven community-based organization that serves member health with excellence and dignity, · respecting the value and needs of each person. · You'll enjoy competitive compensation for this role. · ...

We are breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people united in our mission to put the senior first. · ...

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. · ...

Alignment Health is breaking the mold in conventional health care committed to serving seniors and those who need it most: the chronically ill and frail. · ...

Astiva Health is seeking a full-time Claims Department staff member dedicated to dental affairs. · ...

Astiva Health is seeking a full-time Claims Department staff member dedicated to dental affairs. This role supports accurate, timely dental claims processing, provider education, utilization review support and dental grievance coordination. · ...

The Customer Service Coordinator is responsible for supporting the customer service department. This position will answer all incoming customer service calls and help all callers obtain an answer to their questions and concerns while providing excellent customer service. · Answer ...

The Team You'll Join: We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. · ...