California Licensed Clinical Appeals Manager

Job Summary

To support project-related activities, the remote W2 Contract to Hire California Licensed Clinical Appeals Manager will oversee medical and non-medical appeals decisions, manage staff workflows, and contribute to departmental initiatives during weekday nights.

Key responsibilities

• Plan and manage project activities aligned to contract deliverables
• Lead and facilitate regular team meetings while developing standardized approaches for sharing project information
• Analyze workflow trends and implement improvement strategies to enhance efficiency and control costs

Required qualifications

• Associate's degree or equivalent experience required
• 3-5 years of clinical or medical administration experience
• 3+ years of management or supervisory experience
• Demonstrated experience with medical necessity review
• Active Nursing License preferred, with a background in Nursing, Physical Therapy, Respiratory Therapy, or Occupational Therapy