Director of Appeals and Grievances
Company: VirtualVocations
Location: Jamaica
Posted on: November 18, 2024
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Job Description:
A company is looking for a Director of Appeals and
Grievances.
Key Responsibilities
Manage a large Appeals and Grievance team and ensure compliant
processing of cases
Conduct training, identify improvement opportunities, and ensure
audit activities are performed
Oversee the timely processing of Appeals and Grievances while
meeting Service Level Agreements
Required Qualifications, Training, and Education
Bachelor's degree in business administration, healthcare, or
related field; Master's degree preferred
At least 10 years of experience in a supervisory or management
role, preferably in healthcare or insurance
Minimum of 5 years of experience in a grievance and appeals
environment with knowledge of CMS regulations
Experience in medical benefits and healthcare industry
regulations
Certification or progress toward certification in a relevant field
is highly preferred
Keywords: VirtualVocations, Plainfield , Director of Appeals and Grievances, Executive , Jamaica, New Jersey
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