Manager of Appeals and Grievances
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Manager, Appeals and Grievances.
Key Responsibilities
Monitor and manage intake for specialty appeals and oversee
non-clinical staff training and performance
Facilitate adherence to timeliness and accuracy standards, while
managing staff productivity and work assignments
Consult with clinical and claims staff on problem cases and assist
in data gathering for reports and audits
Required Qualifications
Management experience in a health care setting, preferably in
Utilization Management
Minimum of 5 years in Utilization Management, health care appeals,
compliance, or grievances in a quality improvement environment
Strong working knowledge of Microsoft Office products
Experience in training and developing staff in specialized
tasks
Ability to analyze reports regarding appeal and provider dispute
activity
Keywords: VirtualVocations, Orange , Manager of Appeals and Grievances, Executive , Vista, California
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