Duals Supervisor, Appeals And Grievances

Mass General Brigham Health Plan Holding Company, Inc.

Somerville, MA, United States
Base: $79,560.00 - $115,720.80 annual; bonus/equit...
Fully remote
3-5 years billing claims or appeals experience
1-2 years supervisory leadership role
Knowledge of ncqa cms and eohhs regulations
The role provides day-to-day supervision of a team responsible for the Appeals and Grievances line of business within Mass General Brigham Health Plan

Job Summary

  • The role provides day-to-day supervision of a team responsible for the Appeals and Grievances line of business within Mass General Brigham Health Plan.
  • The supervisor ensures strict compliance with Massachusetts Division of Insurance, CMS, and NCQA guidelines while managing risk and efficiency.
  • This is a remote position offering competitive salaries, flexible work options, and comprehensive benefits including career growth opportunities.

Matching Summary

The role provides day-to-day supervision of a team responsible for the Appeals and Grievances line of business within Mass General Brigham Health Plan.

Salary

Base: $79,560.00 - $115,720.80 Annual; Bonus/Equity: Not specified; Benefits: Comprehensive package with flexible work options and career advancement

Skills & Requirements

Must-have

  • 3-5 years billing claims or appeals experience
  • 1-2 years supervisory leadership role
  • Knowledge of NCQA CMS and EOHHS regulations
  • Experience with Medicare Dual Special Needs Programs
  • Team supervision of 4-6 coordinators

Nice-to-have

  • Experience setting up workflows for new products
  • Cross-functional collaboration skills
  • Process improvement and cost savings initiatives
  • Strong stakeholder relationship building

Key Requirements

  • Associate's degree required
  • 3-5 years in billing, claims, or appeals management
  • 1-2 years in supervisory or leadership capacity
  • 5-7 years health plan operations experience preferred
  • 2-3 years Medicare/Dual Special Needs Program experience preferred

Work Rights

Not specified

Tailored Resume

Cover Letter