Operations Supervisor
1 week ago
The Commercial Appeals & Grievances department at Blue Shield of California performs comprehensive research related to the facts and circumstances of member complaints, appeals, and grievances.
The Commercial Appeals & Grievances Supervisor will report to the Commercial Appeals & Grievances Senior Manager.
Key Responsibilities- Be responsible for routine operations and people management functions
- Foster a great place to work by communicating clear roles and responsibilities and building successful working relationships across the organization
- Consult and make recommendations to management on operational issues
- Use concepts and abilities to manage processes and operations, including procedural changes, inventories, and workload management
- Apply policies and procedures within health care operations
- Stay up to date on legislation and regulations to ensure team compliance
- Interpret audit information requests, prepare narratives, conduct preliminary risk assessments, anticipate adverse findings to prepare for internal corrective action plans
- Make decisions on people and operational matters consistent with goals and objectives
- Provide coaching, performance management, skill development, and guidance on team members' Professional Development Plans
- Perform other related duties as assigned
- Requires a High School Diploma or GED
- Requires a minimum of 5 years of prior relevant experience
- Requires a minimum of 2 years of experience operating in a lead role or equivalent leadership training or manager training
- Requires related experience and/or training, or equivalent combination of education and experience
- Must have experience in appeals and grievances and preferred experience in claims, customer service, installation & billing, or member services role in the health care industry
- Appeals and Grievances experience required
- Understands basic supervision/management approaches such as work scheduling, prioritizing, coaching and process execution
- Requires broad knowledge of technical or operational practices within assigned discipline
- Commercial healthcare experience preferred
- Must be willing to work weekends and holidays as needed
You may be placed in a specialty client, or other unit, such as CalPERs.
The pay range for this role is: $66,600 to $98,900 for California.
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