Grievance Management Supervisor
2 months ago
Position: Supervisor of Grievance & Appeals
Company: VillageCare MAX
The Supervisor of Grievances and Appeals is responsible for overseeing the investigation and resolution of member complaints and grievances. This role involves managing all facets of the grievance system processes in alignment with regulatory requirements, ensuring that grievances are investigated and processed efficiently and accurately.
In this capacity, you will establish and maintain a framework that guarantees consistent resolution responses are available to all operational teams and subject matter experts. You will also ensure that all regulatory reports and timelines are adhered to by conducting ongoing compliance audits, thereby promoting member satisfaction.
Your responsibilities will include:
- Managing team productivity and resources.
- Communicating productivity expectations effectively.
- Balancing workloads to achieve customer satisfaction through timely and accurate handling of concerns.
- Identifying trends related to both clinical and non-clinical issues, reporting findings, and recommending actionable solutions.
Ideal candidates will possess a Bachelor's Degree in a relevant field and have 3-5 years of experience in Managed Long Term Care. Familiarity with the Medicare/Medicaid grievance and appeals process is essential. Proficiency in general office software, including Microsoft Excel, Word, and Outlook, is also required.
VillageCare offers a comprehensive benefits package, including competitive compensation, a 403(b) retirement plan, and a variety of at-home and community-based services. We are dedicated to achieving superior outcomes in quality health care.
VillageCare is an Equal Opportunity Employer.
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