Grievance & Appeals Manager (Remote/Hybrid)
PA Health & Wellness
- Remote job
Centene is seeking a clinical professional to join our Medical Management/Health Services team to ensure proper processing of member grievances, provider appeals, and state fair hearings. You will serve as the primary contact with the State and oversee the daily activities of the Grievance & Appeals Coordinators. Bachelor’s degree or equivalent experience is required with 3+ years in healthcare or law, plus leadership experience managing cross-functional teams on large projects. #J-18808-Ljbffr PA Health & Wellness
$30 - $35 per hour
...seeking a Mid-Senior Level professional for a contract role to manage grievances and appeals. Candidates should have 6+ years in customer service with... ...range of $30.00/hr - $35.00/hr based on qualifications. Remote work is available for candidates within 100 miles of...Remote jobContract workFor contractors- CVS Health is seeking a Senior Manager, Quality Assurance and Audit to lead the Grievance & Appeals QA program across Medicare, Medicaid, and Duals. You will shape strategy... ...environment. You will build and mentor a remote team of Quality Analysts, partner with cross‑functional...Remote job
$27 - $31 per hour
Pyramid Consulting, Inc. is seeking an Appeals & Grievances Case Manager for a California assignment in Los Angeles. This is a 06+ months contract with potential for extension, and is listed as remote in the LA area. The role requires extensive appeals experience within...Remote jobHourly payContract work$67.9k - $182.55k
...in the US Position Summary The Senior Manager, Quality Assurance and Audit is a critical... ...of quality programs within the Grievance & Appeals QA organization. This role ensures operational... ...a team of Quality Analysts in a remote environment Track, monitor, and manage...Remote workHourly payFull timeTemporary workWork at officeLocal area- ...Grievance & Appeals CoordinatorAre you an analytical problem solver with a passion for healthcare managed care? We are seeking dedicated Grievance & Appeals Coordinators to join our growing... ..., collaborative team! In this fully remote role, you will analyze and resolve...Remote workWork from homeHome officeWeekend work
$40k - $52.3k
...Grievances & Appeals Representative Become a part of our caring community... ...& Appeals Representative 2 manages client denials and concerns... ...Requirements: To ensure Home or Hybrid Home/Office employees'... ...Travel: While this is a remote position, occasional travel...Remote workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayShift work- Moda Health is seeking a motivated professional to investigate and respond to medical, pharmacy and dental grievances, complaints, and appeals. This is a full-time work-from-home position within Government Programs. Responsibilities include thorough case review, timely...Remote jobFull timeWork from home
$116.3k - $264.6k
UCLA Health is seeking a Labor Relations Manager to provide leadership and guidance on UC policies. This role includes directing grievance processes and serving as a key resource for... .... This position offers a flexible hybrid work environment and a competitive salary...Remote jobFlexible hours$248.5k - $373k
...!You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you... ...challenges. Primary Responsibilities:The Appeals and Grievances Medical Director is responsible for... ...Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses...Remote workMinimum wageWork experience placementLocal areaWork from home$19.43 - $32.98 per hour
## Grievance and Appeals Coordinator IApplylocations: Remote-AZtime type: Full timeposted on: Posted Yesterdayjob requisition... ...professional on our Medical Management/Health Services team. Centene is... ...flexible approach to work with remote, hybrid, field or office work schedules....Remote workFull timePart timeLive inWork at officeFlexible hours- ...decisions. At AZ Blue, we have a hybrid workforce strategy, called... ...as hybrid, onsite or remote. While the majority of our employees... ...clinical acumen and managed care expertise related to researching... ...for member and provider appeals, grievances, reconsiderations and...Remote jobContract workWork experience placement1 day per week
- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote work
- CVS Health in the United States is seeking a Senior Manager, Quality Assurance and Audit to lead the G&A QA program across Medicare, Medicaid... ...compliance in a highly regulated environment while guiding a remote team of quality analysts. You will oversee internal and...Remote job
- CVS Health in the United States seeks a Senior Manager, Quality Assurance and Audit to lead QA programs across Medicare, Medicaid, and... ...develop a high-performing team of Quality Analysts in a largely remote environment. This role requires strategic thinking, cross-...Remote work
- DescriptionAccounting ManagerBaltimore, MD | Hybrid (2 Days Onsite / 3 Days Remote)Why This Opportunity Stands OutA global industry leader is seeking an Accounting Manager to join its Baltimore-area team. This is an outstanding opportunity for an experienced Senior Accountant...Remote workWork from homeFlexible hours
$181k - $226k
...Brex is seeking a Relationship Manager for its Startups team in San Francisco. This pivotal role involves managing a portfolio of approximately... ...an OTE range of $181,000 - $226,000. This position offers a hybrid work environment with flexible work-from-home options. #J-18808...Remote workWork from homeFlexible hours- ...To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members and providers while ensuring compliance with applicable requirements. Key responsibilities Manage and resolve complaints...Remote workFull time
$120k - $150k
...Overview Manager, Care Strategy and Operations Total Compensation: $120-150K base + commission + equity Schedule: Full-time Location: Las Vegas - starting remotely, then hybrid Role Type: Full-time About Everself Everself is on a mission to cure...Remote workFull timeWork at officeFlexible hours$149.92k - $166.58k
...Eversource supports work-life balance by offering hybrid schedules for certain roles. Eligibility... ...guidelines apply to roles approved for remote work and are subject to change, based on... ...change.This position is responsible for managing, developing, standardizing, coordinating...Remote workFull timeH1bWork at office$110k - $175k
...of Food People!The Community Affairs Senior Manager is responsible for developing, implementing,... ...it serves.This position has been segmented as Hybrid meaning there is a combination of three onsite days and the rest remote. Responsibilities:Develop, manage, execute and...Remote workMinimum wageFull timeTemporary workLocal area$119.1k - $178.5k
*This role is hybrid in Stillwater, MN or Hopkins, MN and requires working 3 days per week in office.Job Overview: The Senior Manager of Merchandising Analytics is responsible for leading and... ...split between onsite and remote work is determined by the manager....Remote workHourly payFull timeWork at officeImmediate startFlexible hoursShift work3 days per week- Santa Barbara Cottage Hospital is seeking a Grievance and Appeals Nurse for a remote position based in Indiana. Responsibilities include investigating... ...Director approval. Candidates need at least 2 years in managed care and an IN RN license, with MCG experience and preferred...Remote job
$107.5k - $204.5k
...Rita Rd ~ BLDG 9030 Position Role Type:Hybrid U.S. Citizen, U.S. Person, or Immigration... ...and defense.Raytheon has an opening for a Manager, Contracts in the Strategic Initiatives... ...role is designated as on-site, hybrid or remote.The salary range for this role is 107,500...Remote workContract workTemporary workWork experience placementWork at officeFlexible hours$90k - $100k
...[Hybrid] Sales Manager (Freight/Export Logistics exp req) Location: Carlsbad, CA Salary: $90,000 - $100,000 DOE + Quarterly Gross Profit... ...Type: Full-Time Schedule: Hybrid; 3 days onsite / 2 days remote after training period Travel: Minimal; occasional customer...Remote workFull timeImmediate startRelocation package- ...measurable business outcomes.Role OverviewAs Integrated Marketing Manager for ABM, you will own full-funnel, multi-channel campaign... ...and sport courses in select locations.Flexibility: Hybrid or remote options (depending on location) and flexible working hours to...Remote workFlexible hours
$102.18k
...Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department:... ...The position supports the A&G Clinical Manager. This role also assists the A&G Leadership... ...hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours...Remote workFull timeShift workWeekend work- ...the Change. Elevate the Care. Shape the Future of Quality at SRHS. Join us as our next Remote Quality Manager!Spartanburg Regional Healthcare SystemLocation: Spartanburg, SC (Hybrid). Must reside within a commutable distance as travel to any of our locations may be needed...Remote work
- Ennoble Care seeks an experienced Full-time BHI Specialist (Hybrid) to support our Virginia patients. This role blends remote work with occasional home visits, focusing on behavioral health care management for a defined caseload. Candidates should have an MSW and behavioral...Remote jobFull timeWork from home
$23.22 - $34.84 per hour
A leading health insurance provider is seeking a Grievance & Appeals Coordinator to work virtually full-time, with responsibilities including summarizing complaints, ensuring resolution of grievances, and documenting interactions. The ideal candidate should possess a high...Remote workHourly payFull time- Atlantic Group is seeking a Geriatric Care Manager (Social Worker) in Queens, NY to support care management and advocacy for older adults. This hybrid role involves home visits and remote work to help seniors access resources and improve quality of life. The ideal candidate...Remote workWork from home
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