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Manager of Appeals and Grievance
JOB SUMMARYThe Manager of Appeals and Grievance is responsible for leading, organizing and directing the team responsible for reviewing, researching, investigating, negotiating and resolving Member and Provider complaints, appeals and grievances for all lines of business to include Medicare, Medicaid, CHIP, Commercial Products, and ASO products.ESSENTIAL FUNCTIONS OF THE ROLEManages staff responsible for the resolution of member complaints, grievances and appeals for the health plan, ensuring resolutions are compliant with established policies, procedures and regulatory requirements.Develops and evaluates direct reports and employees. Provides timely and direct feedback


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