Grievance Program definition

Grievance Program means the procedures established by Health Plan to timely address Member and Provider complaints or grievances.
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Grievance Program means the procedures established by Health Plan to timely address Enrollee and Provider complaints or grievances. Molina ECMS ref# 729 Provider or authorized MHC v122706 / MHI v091707 representative’s initials: Pacific Hospital of Long Beach
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Grievance Program means the procedures established by Health Plan to timely address Member and Provider complaints or grievances. Health Plan means VENTURA COUNTY MEDI-CAL MANAGED CARE COMMISSION, a public entity doing business as Gold Coast Health Plan.
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Examples of Grievance Program in a sentence

  • Provider shall participate in Health Plan’s Grievance Program and shall cooperate with Health Plan in identifying, processing, and promptly resolving all Member complaints, grievances, or inquiries.

  • The court also notes that the regulations governing the Inmate Grievance Program encourage the inmate to “resolve his/her complaints through the guidance and counseling unit, the program area directly affected, or other existing channels (informal or formal) prior to submitting a grievance.” Id. § 701.3(a) (Inmate’s Responsibility).

  • Violation of The Requirements for the Conduct of Mediation and Mediators in the State Employee Grievance Program may result in disqualification from the Commission=s Roster of Mediators for the State Employee Grievance Program.

  • Providers are required to participate in North Sound BH-ASO’s Grievance Program and cooperate with North Sound BH-ASO in identifying, processing, and promptly resolving all individual complaints, grievances, or inquiries.

  • For the purposes of the Oklahoma Department of Human Services (OKDHS) Grievance Program procedure, time is calculated in terms of calendar days.

  • The OKDHS Grievance Program is available to all probationary and permanent classified and unclassified employees.

  • These requirements serve as the foundation for the conduct of mediators practicing in the State Employee Grievance Program.

  • Section 14.005, Chapter 110 Texas Civil Practice and Remedies Code; Sections 493.014 and Section 501.008, Texas Government Code mandate that TDCJ operate an Offender Grievance Program that qualifies for federal certification and that we obtain and maintain that certification.

  • The Requirements set out in this document shall apply to all mediators included on the Arkansas Alternative Dispute Resolution Commission=s Roster of Certified Mediators for the State Employee Grievance Program.

  • Complaints of illegal discrimination, including sexual harassment, are especially serious and an employee may seek relief through any or all of the following: the OKDHS Grievance Program, the OKDHS Office for Civil Rights, the Equal Employment Opportunity Commission, or the Oklahoma Merit Protection Commission.


More Definitions of Grievance Program

Grievance Program means a formalized set of activities designed to provide Members and Providers, exercising their rights under applicable state and federal law, to a fair and solution-oriented process to address a perceived problem with the operations of the PLAN, including delivery and access to care, in a reasonable amount of time. This Program includes provisions for evaluation of complaints, assessments of trends, implementation of actions to correct identified problems, mechanisms to communicate actions and results to the appropriate health plan employees and contracting providers.
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Related to Grievance Program

  • Grievance Procedure is used in this Agreement, it shall be considered as including the arbitration procedure.

  • Grievance means a complaint in writing that an employee, group of employees, or the Union submits to management, to be processed through the grievance procedure.

  • Grievance System means the overall system that includes:

  • Group Grievance is defined as a single grievance, signed by a Xxxxxxx or a Union Representative on behalf of a group of employee who have the same complaint. Such grievances must be dealt with at successive stages of the Grievance Procedure commencing with Step 1. The grievors shall be listed on the grievance form.

  • Policy Grievance shall be signed by a xxxxxxx or a Union representative or, in the case of an Employer's policy grievance, by the Employer or its representative.

  • Quality Assurance Program means the overall quality program and associated activities including the Department’s Quality Assurance, Design-Builder Quality Control, the Contract’s quality requirements for design and construction to assure compliance with Department Specifications and procedures.

  • Grievance Committee means the Grievance Committee of the Bar.

  • Disciplinary sanction means any action listed in s. UWS 14.04 taken in response to student academic misconduct.

  • Compliance Program means the program established by CNYCC to prevent, detect, and address compliance issues that arise with respect to PPS operations, projects or activities.

  • A grievance means a dispute or disagreement as to the interpretation or application of terms and conditions of employment contained in this Agreement.

  • Multidisciplinary team means a group of individuals who possess knowledge and skills related to the diagnosis, assessment, and disposition of child abuse cases and who are professionals practicing in the disciplines of medicine, nursing, public health, substance abuse, domestic violence, mental health, social work, child development, education, law, juvenile probation, or law enforcement, or a group established pursuant to section 235B.1, subsection 1.

  • PACE Program means a program implemented by a municipality to stimulate energy efficiency and renewable energy projects in conformity with Act 270.

  • Statement of Grievance shall name the grievant(s) involved, the facts giving rise to the grievance, the provision(s) of the Agreement alleged to be violated, and the remedy (specific relief) requested.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Disciplinary Committee means any person or committee of persons, or any subcommittee thereof, that is author- ized by a self-regulatory organization to issue disciplinary charges, to con- duct disciplinary proceedings, to settle disciplinary charges, to impose dis- ciplinary sanctions or to hear appeals thereof.

  • Grievances filed under this Article shall begin at Step 2. Grievances under this clause shall be handled with all possible confidentiality and dispatch.

  • Grievant means an employee or group of employees having the same grievance. In the case of a group of employees, one employee shall be designated by the group to act as spokesperson and to be responsible for processing the grievance.

  • Interdisciplinary team means a group of persons with varied professional backgrounds who meet with the member to develop a comprehensive service plan to address the member’s need for services.

  • Apprenticeship program means a program registered with the U.S. Department of Labor, Office of Apprenticeship, which includes terms and conditions for the qualification, recruitment, selection, employment, and training of apprentices, including the requirement for a written apprenticeship agreement.

  • Quality Management Plan means the portion of the Project Development Plan providing the information requested in Section 4.3 of Exhibit B to the ITP.

  • Mobile crisis outreach team means a crisis intervention service for minors or families of minors experiencing behavioral health or psychiatric emergencies.

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Training program means an NCA-approved Iowa college, the Iowa law enforcement academy or an Iowa hospital approved by the department to conduct emergency medical care training.

  • Maintenance Program means LESSEE's maintenance program as approved by the Aviation Authority or such other maintenance program as LESSOR may, in its discretion, accept in writing.

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).