Student Veterans of America Jobs

Welcome to SVA’s jobs portal, your one-stop shop for finding the most up to date source of employment opportunities. We have partnered with the National Labor Exchange to provide you this information. You may be looking for part-time employment to supplement your income while you are in school. You might be looking for an internship to add experience to your resume. And you may be completing your training ready to start a new career. This site has all of those types of jobs.

Here are a few things you should know:
  • This site is mobile friendly. You do not need a log-in or password to access information.
  • Jobs on this site are original and unduplicated and come from three sources: the Federal government, state workforce agency job banks, and corporate career websites. All jobs are vetted to ensure there are no scams, training schemes, or phishing.
  • The site is refreshed daily to remove out-of-date content.
  • The newest jobs are listed first, so use the search features to match your interests. You can look for jobs in a specific geographical location, by title or keyword, or you can use the military crosswalk. You may want to do something different from your military career, but you undoubtedly have skills from that occupation that match to a civilian job.
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Job Information

Centene Corporation Grievance & Appeals Coordinator II in Woodland Hills, California

Position Purpose:

Analyze and resolve verbal and written claims and authorization grievance/appeals from providers and members. Resolve all State inquires related to complaints, grievances and appeals.

  • Review and process member and provider grievances and appeals within federal, state and organizational regulations and policies and procedures

  • Review claim grievance for reconsideration and either approve/deny based on determination level or prepare for medical review presentation. Prepare cases for medical review as necessary

  • Review and determine if claim grievance includes a potential quality or access issue

  • Collaborate with subject matter experts within the organization to obtain benefit and/or clinical opinions/interpretations of complex cases

  • Serve as liaison between member, provider regulatory agencies and internal staff. Correspond with key individuals regarding grievance and appeal decisions.

  • Act as subject matter expert regarding grievances and appeals.

  • Lead Appeals and Grievance Committee

Education/Experience:

Bachelor’s degree in related field or equivalent experience. 2+ years of claims, contracting, or related experience in a managed care environment.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

TITLE: Grievance & Appeals Coordinator II

LOCATION: Woodland Hills, California

REQNUMBER: 1202965

COMPANY: Clinical & Care Management

POSITION TYPE: Both

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