Team Lead Clinical Appeals

Job Summary

A company is looking for a Team Lead, QI Clinical Appeals.

Key Responsibilities

• Lead a team to coordinate and monitor clinical appeal and state hearing processes
• Track and analyze reports related to clinical appeals and ensure compliance with regulations
• Develop and implement SOPs and training tools while managing staffing and scheduling functions

Required Qualifications

• Bachelor's Degree or equivalent relevant work experience
• Three (3) years of previous management/leadership experience preferred
• Experience with FACETS preferred
• Healthcare and/or HMO experience preferred
• Proficiency in Microsoft Office applications