Supervisor of Grievance & Appeals

Supervisor of Grievance & Appeals

VillageCare MAX

112 Charles Street, New York, NY 10014

Must reside in NY, NJ or CT

The Supervisor of Grievances and appeal grievances oversees the investigations and resolution of comp laints and grievances from members. Managing a ll aspects of the grievance system processes consistent with DOH and CMS requiremen ts for members, and working to i nvestigate and processes grievances for members in a timely, accurate manner consistent with law and contract requirements and terms.

As the Supervisor, you will bui ld and maintain an infrastructure to assure consistent resolution responses are accessible to all operational teams and business units and subject matter experts. You will be responsible to ensure that all regulatory reports and time frames are met by conducting on-going compliance audits to ensure compliance and member satisfaction. Manages team's productivity and resources, communicates productivity expectations and balances workload to achieve customer satisfaction through prompt / accurate handling of customer concerns. Identifies trends involving non-clinical & clinical issues and reports on and recommends solutions.

We would like to speak to those who have a Bachelor's Degree in a related field along with 3-5 years of Managed Long Term Care experience. Knowledge of Medicare / Medicaid Grievance and appeals process. Proficient with general computer software including Microsoft Excel, Word and Outlook.

There are many benefits to working for VillageCare. If you are someone who likes being part of a team, enjoys highly competitive compensation and benefits package, a 403(b) retirement plan and much more than we would love to speak with you! VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible. We are committed to superior outcomes in quality health care.

VillageCare is an Equal Opportunity Employer.

Job Posted by ApplicantPro