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New York State Licensed Appeals Director
A company is looking for a Director - Appeals (Health Insurance, Disability, Workers Compensation). Key Responsibilities Act as the primary contact for the state client and ensure program compliance with regulations Oversee project operations, including budget management and performance goal achievement Conduct medical necessity reviews and ensure compliance with workers' compensation standards Required Qualifications Bachelor's degree in a relevant field and 10+ years of professional experience Experience in workers' compensation or utilization review preferred Knowledge of workers' compensation laws and regulations Familiarity with medical management practices and clinical guidelines Proficiency in claims management software and related tools
A company is looking for a Director - Appeals (Health Insurance, Disability, Workers Compensation).
Key Responsibilities
Act as the primary contact for the state client and ensure program compliance with regulations
Oversee project operations, including budget management and performance goal achievement
Conduct medical necessity reviews and ensure compliance with workers' compensation standards
Required Qualifications
Bachelor's degree in a relevant field and 10+ years of professional experience
Experience in workers' compensation or utilization review preferred
Knowledge of workers' compensation laws and regulations
Familiarity with medical management practices and clinical guidelines
Proficiency in claims management software and related tools
