Appeals Manager

North Carolina Department of Health and Human Services

North Carolina, US
$63,927 - $111,871 py
Hybrid
Medicaid appeals and grievances
Provider and beneficiary appeals
Due process compliance
The purpose of this position is to work as an integral member of the Medicaid Appeals team that provides oversight of appeal and grievance functions, processes, and initiatives, troubling shooting issues, and other tasks and items that arise for Medicaid Beneficiary Appeals and grievances and Provider Claim appeals

Job Summary

  • The purpose of this position is to work as an integral member of the Medicaid Appeals team that provides oversight of appeal and grievance functions, processes, and initiatives, troubling shooting issues, and other tasks and items that arise for Medicaid Beneficiary Appeals and grievances and Provider Claim appeals.
  • The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees.
  • The State of North Carolina offers excellent comprehensive benefits including health insurance, retirement plans, NCFlex program, and paid leave.

Matching Summary

The purpose of this position is to work as an integral member of the Medicaid Appeals team that provides oversight of appeal and grievance functions, processes, and initiatives, troubling shooting issues, and other tasks and items that arise for Medicaid Beneficiary Appeals and grievances and Provider Claim appeals.

Salary

$63,927 - $111,871

Skills & Requirements

Must-have

  • Medicaid appeals and grievances
  • Provider and beneficiary appeals
  • Due process compliance
  • Legal research and analysis
  • Stakeholder coordination

Nice-to-have

  • Effective working relationships
  • Healthcare industry knowledge
  • Program management understanding
  • Microsoft Office proficiency

Key Requirements

  • Master's degree or Bachelor's degree in area of assignment
  • 3-5 years of closely related experience
  • Equivalent combination of education and experience

Work Rights

Not specified

Tailored Resume

Cover Letter