Manager of Grievances and Appeals

Virtual Vocations Inc · Workfromhome, United States

Managing daily operations within the Grievance and Appeals program, the full-time Manager of Grievances and Appeals will ensure efficient and compliant handling of appeals and grievances for members while leading the team remotely. Key responsibilities Oversee the Grievance and Appeals team to achieve organizational goals and manage productivity Establish and maintain effective workflows and processes to ensure timely completion of grievance and appeal functions Ensure compliance with regulatory standards and provide training to staff on case review procedures Required qualifications Bachelor's Degree or equivalent experience in Healthcare or a related field 5+ years of experience in a managed health care setting, preferably with Medicare/Medicaid Demonstrated management experience and strong leadership skills Working knowledge of guidelines and regulations relevant to Grievance and Appeals Advanced proficiency in Microsoft Office Suite