Manager of Appeals and Grievances

A company is looking for a Manager, Appeals and Grievances. Key Responsibilities Monitor and manage intake for specialty appeals and oversee non-clinical staff training and performance Facilitate adherence to timeliness and accuracy standards, while managing staff productivity and work assignments Consult with clinical and claims staff on problem cases and assist in data gathering for reports and audits Required Qualifications Management experience in a health care setting, preferably in Utilization Management Minimum of 5 years in Utilization Management, health care appeals, compliance, or grievances in a quality improvement environment Strong working knowledge of Microsoft Office products Experience in training and developing staff in specialized tasks Ability to analyze reports regarding appeal and provider dispute activity

Apr 29, 2025 - 15:20

A company is looking for a Manager, Appeals and Grievances. Key Responsibilities Monitor and manage intake for specialty appeals and oversee non-clinical staff training and performance Facilitate adherence to timeliness and accuracy standards, while managing staff productivity and work assignments Consult with clinical and claims staff on problem cases and assist in data gathering for reports and audits Required Qualifications Management experience in a health care setting, preferably in Utilization Management Minimum of 5 years in Utilization Management, health care appeals, compliance, or grievances in a quality improvement environment Strong working knowledge of Microsoft Office products Experience in training and developing staff in specialized tasks Ability to analyze reports regarding appeal and provider dispute activity