Job Description:
• Oversee Quality staff, including organization and development of high-performing teams
• Work with functional area managers to ensure consistency in monitoring and reporting activities
• Manage performance and resources for monitoring needs
• Select, train, coach, and develop staff
• Collaborate to identify trends and recommend solutions
• Validate team effectiveness through scorecards and monitoring
• Facilitate and present at Appeals team meetings
• Accommodate team needs with a solutions-based attitude
• Mentor the team on processes, problem resolution, and critical thinking
• Act as a liaison with other key business areas
• Assist in developing and facilitating new training
• Participate in staff hiring
• Create a positive workspace by recognizing contributions, soliciting input, and assisting as needed
Requirements:
• 5+ years Medicare Appeals background
• Microsoft Office experience
• Knowledge of Appeals job aids/workflows
• Strong Communication skills - ability to provide and receive feedback
• Excellent time management skills
• Requires working knowledge of regulatory and accreditation requirements, benefit plan and/or contractual arrangements
• 2+ years Quality experience (preferred)
• QuickBase experience (preferred)
• Training or leadership/management experience (preferred)
• Knowledge of CMS guidance (preferred)
Benefits:
• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources supporting physical, emotional, and financial well-being