and to make recommendations for streamlining the grievance and appeals process within the functional units of the department...Summary of Job Responsible for overseeing the day-to-day operations of the Grievance and Appeal Specialists, ensuring...
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...
Affairs, Grievance and Appeals, Compliance, Membership Eligibility Unit, Quality as needed. Participates in requests for out... Consult with supervisor and others in overcoming barriers in meeting goals and objectives. Maintains current knowledge...
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...