Manager of Grievance Appeals

A company is looking for a Manager, Grievance & Appeals Operations. Key Responsibilities Oversee the Grievance and Appeals Department's daily operations and productivity to align with organizational goals Ensure timely completion of grievance, appeal, and complaint functions by maintaining effective workflows and monitoring processes Manage staff performance and training, ensuring compliance with regulatory standards and fostering a culture of teamwork Required Qualifications Bachelor's Degree in Healthcare or a related field or equivalent experience 5+ years of experience in a managed health care setting, specifically in Medicare Advantage/Medicaid Grievance and Appeals Knowledge of relevant guidelines and regulations related to Grievance and Appeals Demonstrated management experience with strong strategic planning and leadership skills Ability to work on Pacific Time hours

Mar 13, 2025 - 09:19

A company is looking for a Manager, Grievance & Appeals Operations. Key Responsibilities Oversee the Grievance and Appeals Department's daily operations and productivity to align with organizational goals Ensure timely completion of grievance, appeal, and complaint functions by maintaining effective workflows and monitoring processes Manage staff performance and training, ensuring compliance with regulatory standards and fostering a culture of teamwork Required Qualifications Bachelor's Degree in Healthcare or a related field or equivalent experience 5+ years of experience in a managed health care setting, specifically in Medicare Advantage/Medicaid Grievance and Appeals Knowledge of relevant guidelines and regulations related to Grievance and Appeals Demonstrated management experience with strong strategic planning and leadership skills Ability to work on Pacific Time hours