procedures and workflow and to make recommendations for streamlining the grievance and appeals process within the functional...Summary of Position Responsible for overseeing the day-to-day operations of the Grievance and Appeal Specialists...
What You Will Do: Supervises the day-to-day operations of VNS Health Plans Grievance & Appeals departments clinical and non-clinical staff. Makes... years experience in health care requiredMinimum of two years experience with Grievance and Appeals in a Medicare...
Summary of Position Perform clinical and administrative reviews within the Grievance and Appeals department, ensuring..., timely and professional manner. Maintain an understanding of utilization management/grievance and appeals program objectives...
that affect member eligibility. Coordinates with other departments, e.g. Care Management, Legal Affairs, Grievance and Appeals... options and contributes to the development of a safe member centered service plan Consult with supervisor...