Appeals Grievance Supervisor

Job Summary

A company is looking for an Appeals Grievance Supervisor.

Key Responsibilities

• Oversee the daily operations of staff handling member complaints, appeals, and grievances
• Prepare and submit required Appeals & Grievances reports to regulatory agencies
• Provide leadership and training to staff, ensuring compliance with regulatory standards

Required Qualifications

• Four years of experience in a managed care environment, specifically with Medicare
• Experience in grievance and appeals processing
• Participation in CMS/Medicare audits and completion of corrective action plans
• Bachelor's degree or equivalent in health, business, social sciences, or related field
• Strong computer skills, particularly in Microsoft Office Suite