Appeals and Grievances Supervisor Jobs | Glassdoor
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Appeals and Grievances Supervisor Jobs

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  • 3.8
    Sharp HealthCare – San Diego, CA
    14 days ago 14d
    Description Summary The Supervisor- Appeals/Grievances is responsible for leading the appeals and grievances unit, which investigates… SupervisorAppeals and Grievances - 79419 Qualifications Location This position is located in Kearny Mesa, San Diego…
  • 2.9
    Centene Corporation – Columbus, OH
    8 days ago 8d
    Position Purpose: The Supervisor of Appeals & Grievances is accountable for the recruitment, hiring, promotion, counseling, and… and counsels non-clinical Grievance and Appeals staff. Orients and trains new Grievance and Appeals Unit members. Continually…
  • 3.2
    MHN – Columbus, OH
    10 days ago 10d
    Position Purpose: The Supervisor of Appeals & Grievances is accountable for the recruitment, hiring, promotion, counseling, and… and counsels non-clinical Grievance and Appeals staff. Orients and trains new Grievance and Appeals Unit members. Continually…
  • 2.6
    Emblem Health – New York, NY
    7 days ago 7d
    Respond to written/verbal grievances, complaints, appeals and disputes submitted by members and providers in accordance with NCQA… limited to, correspondence, payment disputes, complaints/grievances, and appeals. Work requires exercising considerable independent…
  • 3.8
    Tufts Health Plan – Watertown, MA
    13 days ago 13d
    written appeals and grievances to Appeals and Grievances specialists Enter initial member appeals and grievances data into… Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational aspects…
  • 2.8
    LiveHealthier – Columbus, OH
    10 days ago 10d
    Position Purpose: The Supervisor of Appeals & Grievances is accountable for the recruitment, hiring, promotion, counseling, and… and counsels non-clinical Grievance and Appeals staff. Orients and trains new Grievance and Appeals Unit members. Continually…
  • 1.7
    Blue Cross Blue Shield of Arizona Advantage – Phoenix, AZ
    21 days ago 21d
    The Grievance & AppealsSupervisor serves as an expert of the Medicare Advantage and Medicare Part D appeals and grievance functions… functions and reports directly to the Sr. Manager of Grievance & Appeals. The ideal candidate will supervise the department?s production…
  • 2.8
    CalOptima – Orange, CA
    6 days ago 6d
    policies and procedures regarding the appeals and grievance process. The GARS Supervisor will provide necessary training and guidance… responsibility, i.e. utilization management, quality management, grievances and appeals. Supervisory or lead work experience preferred. Strong…
  • 2.3
    Beacon Health Strategies, LLC – Little Rock, AR
    21 days ago 21d
    currently seeking a dynamic Appeals Coordinator II to join our team at our office in Little Rock, AR. The Appeals Coordinator will be… and provider appeals that are received by Beacon Health Options. Position Responsibilities: Create Appeal Hearing Statements…
  • 3.1
    Kforce – Long Beach, CA
    10 days ago 10d
    seeking a contract Grievance and Appeals Coordinator. Job Purpose: Facilitates member grievance and appeal process by investigation… Essential Job Results: Investigates member grievance and appeal by gathering supporting documentation from internal departments…
  • 3.8
    Tufts Health Plan – Watertown, MA
    Est. Salary $97k-$131k
    13 days ago 13d
    The role of the Appeals and GrievanceSupervisor, through the use of general knowledge of Plan benefits and regulatory requirements… Commercial) including weekend coverage The Supervisor represents the Appeals and Grievances Department and the Plan when working with…
  • 2.3
    HealthSun Health Plans – Miami, FL
    28 days ago 28d
    all other the Appeals and Grievance team members with any concerns or questions that relates to the appeals/grievance process.… benefits, and a 401(k) retirement savings plan. The Grievances and Appeals Manager is responsible for managing the timely and accurate…
  • 3.3
    ConvergeOne – Watertown, MA
    Est. Salary $97k-$130k
    13 days ago 13d
    The role of the Appeals and GrievanceSupervisor, through the use of general knowledge of Plan benefits and regulatory requirements… Commercial) including weekend coverage The Supervisor represents the Appeals and Grievances Department and the Plan when working with…
  • 3.1
    AmeriHealth Caritas – Palm Beach Gardens, FL
    22 days ago 22d
    of the Supervisor of Grievance and Appeals, the Grievance and Appeals Team Lead is responsible for assisting the Grievance and Appeals… Appeals team with questions and for assisting the Grievance and AppealsSupervisor with reports and projects as outlined below…
  • 2.7
    First Transit – Glen Ellyn, IL
    Est. Salary $27k-$43k
    10 days ago 10d
    Grievance and Appeals Coordinator - Call Center The Quality Assurance Specialist - Call Center is responsible for collecting… Assurance Supervisor and General Manager Provides grammatically correct, well-written, and appropriate responses to grievances. Uses…
  • 3.3
    ConvergeOne – Watertown, MA
    13 days ago 13d
    written appeals and grievances to Appeals and Grievances specialists * Enter initial member appeals and grievances data into… Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational aspects…
  • 2.6
    Beacon Health Options – Little Rock, AR
    29 days ago 29d
    currently seeking a dynamic Appeals Coordinator II to join our team at our office in Little Rock, AR. The Appeals Coordinator will be… and provider appeals that are received by Beacon Health Options. Position Responsibilities: Create Appeal Hearing Statements…
  • 3.2
    Universal American – Houston, MN
    8 days ago 8d
    to the appeal or grievance has been achieved. Responsible for the timely and accurate documentation of the grievance or appeal… The Appeals and Grievances Specialist I will be responsible for reviewing and responding to complaints received from members and…
  • 2.6
    FirstGroup America – Glen Ellyn, IL
    10 days ago 10d
    Grievance and Appeals Coordinator - Call Center The Quality Assurance Specialist - Call Center is responsible for collecting… Assurance Supervisor and General Manager Provides grammatically correct, well-written, and appropriate responses to grievances. Uses…
  • 2.9
    Fallon Health – Worcester, MA
    13 days ago 13d
    www.fallonhealth.org. Position Overview: The Supervisor of Member Appeals & Grievances is responsible for the oversight of the daily…      Process appeals/grievances (50% case volume reduction)   Acts as a senior resource person for the Appeals Coordinators and…
  • 3.3
    WellCare – Tampa, FL
    NEW
    health services environment. Previous experience in appeals and/or grievances is preferred. Licenses/Certifications: n/a… within the department. Notifies Supervisor or other appropriate parties of identified patterns of appeals, claim errors, configuration…
  • 3.3
    UnitedHealth Group – Cypress, CA
    27 days ago 27d
    resolving all types of appeals and grievances Communicates with appropriate parties regarding appeals and grievance issues, implications… decisions Analyzes and identifies trends for all appeals and grievances May research and resolve written Department of Insurance…
  • 4.3
    Carenational Healthcare Services – Phoenix, AZ
    EASY APPLY
    NEW
    mandates. Investigating and following up on complaints, grievances and quality issues related to the prior authorization process… contractual mandates. Ensuring that members are notified of appeal rights and that staff distinguish between the Knox-Keene regulations…
  • 4.2
    Integrated Resources – Alpharetta, GA
    7 days ago 7d
    case managers, clinical supervisors, account managers and other personnel in resolving denial and appeal questions.- Responds to… Coordinates appeals process as assigned, attends to risk management issues associated with case management and processes appeal requests…
  • 3.2
    Crisis Response Network, Inc. – Tempe, AZ
    Est. Salary $39k-$64k
    27 days ago 27d
    aspects of the grievance and appeals process to ensure mandated timelines are met. Collaborate with Supervisor in identifying… WHAT WOULD YOU BE DOING? Grievance Specialist Coordinate all aspects of SMI appeals in a timely, courteous and efficient…
  • 4.3
    Carenational Healthcare Services – Santa Cruz, CA
    EASY APPLY
    NEW
    mandates. Investigating and following up on complaints, grievances and quality issues related to the prior authorization process… contractual mandates. Ensuring that members are notified of appeal rights and that staff distinguish between the Knox-Keene regulations…
  • 4.4
    Central California Alliance for Health – Merced, CA
    Est. Salary $60k-$121k
    21 days ago 21d
    mandates; Investigating and following up on complaints, grievances and quality issues related to the prior authorization process… contractual mandates; and Ensuring that members are notified of appeal rights and that staff distinguish between the Knox-Keene regulations…
  • 2.4
    HMSA – Honolulu, HI
    7 days ago 7d
    and effective response and resolution to grievances, complex complaints and appeals that are raised by members and providers relating… highly complex and sensitive member and provider appeals, inquiries and grievances and provides oversight to staff for applying internal…
  • 1.6
    Progressive IT – Nashville, TN
    10 days ago 10d
    supervisory lead over pre-certifications, clinical appeals and grievances. This person should have extensive Medicare Part C experience… supervisory Experience over pre-certifications, clinical appeals, and grievances.…
  • 3.2
    Magellan Health – Glen Allen, VA
    23 days ago 23d
    case managers, clinical supervisors, account managers and other personnel in resolving denial and appeal questions. - Responds to… Coordinates appeals process as assigned, attends to risk management issues associated with case management and processes appeal requests…
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