of Position We are seeking a talented Grievance & Appeals Specialist who will be responsible for responding to written/verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with NCQA, CMS, State, and other regulations. They will process appeals and grievances to facilitate the accurate administration of benefits and clinical

of Position We are seeking a dynamic Grievance and Appeals Dispute Specialist who will be responsible for processing disputes submitted by contracted and non contracted providers. The types of correspondence handled by the individual will include, but is not limited to; correspondence, HQSI/ESMSEF appeals and Cotiviti disputes. This individual will provide technical and ad

Serves in an account management (non sales) role as the primary business to business liaison between ConnectiCare and its provider network and is responsible for all interactions between the organizations. Continuously educates provider community about ConnectiCare and its policies and procedures. Build and develop partnerships with ConnectiCare's Tier I and Tier II provi

of Job To disrupt the traditional wellness point solutions model by growing the revenue and membership of WellSpark Health's products and services. This consists of increasing market awareness of WellSpark Health capabilities, as well as sourcing and adding new clients across multiple sales channels, including direct to employer, through brokers, consultants and associatio

Perform Sales Support functions for Small Group Sales Department that aids in the sales process. Provide technical and administrative support to maximize opportunities for meeting and exceeding new membership sales targets. Prepare new business and renewal proposals for delivery. Gather, review, and analyze information; prepare and deliver reports. Responsibilities Facili