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
Supervise appeals and grievance coordinators
Oversee appeal and grievance processes
Ensure regulatory compliance
The Duals Supervisor provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators and is ultimately responsible for the work product of this team and the Duals line of business

Job Summary

  • The Duals Supervisor provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators and is ultimately responsible for the work product of this team and the Duals line of business.
  • The Supervisor oversees all aspects of the Appeal and Grievance processes in accordance with Massachusetts Division of Insurance, EOHHS, CMS, and NCQA guidelines.
  • Mass General Brigham offers competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

Matching Summary

The Duals Supervisor provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators and is ultimately responsible for the work product of this team and the Duals line of business.

Salary

Base: $79,560.00 - $115,720.80/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package

Skills & Requirements

Must-have

  • Supervise appeals and grievance coordinators
  • Oversee appeal and grievance processes
  • Ensure regulatory compliance
  • Coordinate daily operations
  • Identify areas of risk
  • Present metrics to leadership

Nice-to-have

  • Exceptional member experience
  • Groundbreaking medical discoveries
  • Welcoming and supportive environment
  • People-first organization

Key Requirements

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

Work Rights

Not specified

Tailored Resume

Cover Letter