Clinical Appeals Manager
Company: VirtualVocations
Location: Fontana
Posted on: October 7, 2024
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Job Description:
A company is looking for a Manager, Clinical Appeals &
Grievances to lead a dynamic team in managing clinical appeals and
grievances.
Key Responsibilities:
Manage a team of specialists, focusing on productivity and
performance management
Ensure timely resolution of cases and oversee case preparation for
various appeal processes
Identify process improvements and maintain compliance with internal
and external standards
Required Qualifications:
Bachelor's degree or equivalent work experience
RN or LPN license
Experience in utilization management or appeals and grievance
processing
Management experience in a fast-paced healthcare environment
Understanding of Utilization Review Guidelines and healthcare
appeals
Keywords: VirtualVocations, Ontario , Clinical Appeals Manager, Executive , Fontana, California
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