Appeal Resolution Manager manages the grievance process to review, investigate, document, process, negotiate, and resolve disputed medical, insurance, and other claims. Oversees work activity that is compliant with all regulatory guidelines and policy protocols. Being an Appeal Resolution Manager allocates team resources to ensure an effective and balanced case workload. Applies industry standards and uses best practices in the preparation of legal briefs. Additionally, Appeal Resolution Manager may represent the organization at hearings. Requires a bachelor's degree. Typically reports to a senior manager or head of a unit/department. The Appeal Resolution Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be an Appeal Resolution Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
Responsible for transforming data into actionable insights that will drive strategic initiatives and support key business objectives. The Portfolio Risk Analyst will take a lead role in in developing and maintaining robust reporting and analytics, metrics and key performance indicators while also providing in-depth analysis and recommendations for improving/enhancing line of business performance and effective risk management.
GREENSTATE CULTURE:
At GreenState, we exist to create lasting value for those we serve. We do this by putting immense value into our employees, members and communities. We empower our employees to create endless opportunities, which will then impact the lives of our members and enhance the vitality of our communities.
Salary range for this position is $90,593.36 - $121,250.74/YR with a progressive benefit package.
Performs essential duties and responsibilities in the following areas which may include but are
not limited to those listed and are subject to change.
PI239957475
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