Manager of Appeals and Grievances

Job Summary

A company is looking for a Manager, Appeals & Grievances.

Key Responsibilities

• Manage team responsible for the submission and resolution of member and provider appeals and grievances
• Assess and audit business processes to ensure effective resolution of grievances
• Oversee preparation of reports and correspondence in compliance with regulatory requirements

Required Qualifications

• At least 7 years of managed care experience in a relevant environment
• At least 1 year of management or leadership experience
• Experience with Medicaid and Medicare claims denials and appeals processing
• Previous experience leading projects
• Strong organizational and time management skills