Massachusetts Licensed Appeals Manager

A company is looking for a Manager, Appeals & Grievances. Key Responsibilities Oversee all processes related to the intake, triaging, coordination, and documentation of all appeals and grievances Ensure compliance with state and federal regulations while maintaining quality control processes Present appeal and grievance reports to internal stakeholders and act as a liaison for audits and regulatory matters Required Qualifications Bachelor's degree or equivalent combination of training and experience, plus 5-7 years of related experience Registered nurse preferred At least 5-7 years of experience in appeals and grievances 2-3 years of experience in a supervisory or management role Knowledge of Medicaid, Medicare, and Commercial insurance

Jun 14, 2025 - 12:00

A company is looking for a Manager, Appeals & Grievances. Key Responsibilities Oversee all processes related to the intake, triaging, coordination, and documentation of all appeals and grievances Ensure compliance with state and federal regulations while maintaining quality control processes Present appeal and grievance reports to internal stakeholders and act as a liaison for audits and regulatory matters Required Qualifications Bachelor's degree or equivalent combination of training and experience, plus 5-7 years of related experience Registered nurse preferred At least 5-7 years of experience in appeals and grievances 2-3 years of experience in a supervisory or management role Knowledge of Medicaid, Medicare, and Commercial insurance