Manager, Appeals And Grievances

LA Care Health Plan

Los Angeles, CA, US
$88,854.00 (min.) - $142,166.00 (max.) py
On-site
Member appeals and grievances
Regulatory requirements
Timely resolution
The Manager, Appeals and Grievances is responsible for the centralized intake, logging and triage process for all member appeals and grievances

Job Summary

  • The Manager, Appeals and Grievances is responsible for the centralized intake, logging and triage process for all member appeals and grievances.
  • This position ensures the proper handling of member complaints whether presented by members, their authorized representative, the Ombudsman office, state contractors, member advocates, L.A. Care Board Members, providers, etc.
  • L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO).

Matching Summary

The Manager, Appeals and Grievances is responsible for the centralized intake, logging and triage process for all member appeals and grievances.

Salary

$88,854.00 (Min.) - $142,166.00 (Max.)

Skills & Requirements

Must-have

  • member appeals and grievances
  • regulatory requirements
  • timely resolution
  • cross-functional collaboration
  • policy and procedure updates

Nice-to-have

  • culturally-appropriate manner
  • positive work environment
  • strategic planning participation

Key Requirements

  • Bachelor's Degree or equivalent experience
  • 5 years resolving health care issues
  • 2 years leading staff
  • Proficient in MS Office applications
  • Deep understanding of financial principles

Work Rights

Not specified

Tailored Resume

Cover Letter