Florida Licensed Grievance Director

Job Summary

Overseeing member appeals and grievance processes, the full-time Florida Licensed Grievance Director will manage operational efficiency in grievance departments, implement compliance policies, and lead performance improvement initiatives while working remotely from Florida.

Key responsibilities

• Directs operational management of appeals and grievance functions, focusing on execution and performance enhancement
• Designs and implements policies and procedures to ensure compliance with regulations and addresses performance issues
• Provides fiscal management, including developing operational budgets and leading organizational procedural improvements

Required qualifications

• Bachelor's Degree in a related field; Master's Degree preferred
• 5+ years of experience in grievances, appeals, or healthcare law-related fields
• Previous management experience in managed care operations
• Experience managing cross-functional teams on large-scale projects
• Proven supervisory experience, including hiring and training staff