Appeals and Grievances Clinical Specialist
HFMS HF Management Services is hiring for Appeals and Grievances Clinical Specialist in 15 Locations. Mid level. First seen October 22, 2026; open as of November 13, 2026. Jobs taken straight from company career pages — no aggregator in between.
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- Company
- HFMS HF Management Services
- Where
- 15 Locations
- Level
- Mid
- First seen
- October 22, 2026
- Listed via
- Workday
What the posting says
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The A&G Clinical Specialist is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal and/or State regulations. The incumbent will manage his/her…
Read more and apply on HFMS HF Management Services' site
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