1 Manager, Appeals and Grievances / Clinical Review Job in Brooklyn, NY
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Manager, Appeals and Grievances / Clinical Review
$102k-130k (estimate)
Full Time
2 Days Ago
RCM Health Care Services is Hiring a Manager, Appeals and Grievances / Clinical Review Near Brooklyn, NY
Manager, A&G Clinical Review - Hybrid
Salary: $115k - $140k
Location: Manhattan, NY
Responsibilities
Salary: $115k - $140k
Location: Manhattan, NY
Responsibilities
- Responsible for direct oversight and management of clinical review processes within Appeals & Grievances Department.
- Ensures regulatory compliance and timely processing for the Medicare and Medicaid appeal and grievance processes, quality of care concerns and any other inquires requiring clinical review for medical necessity, appropriateness of service or clinical quality.
- Acts as subject matter expert to internal departments and delegated vendors to assure all are educated and complaint with requirements of appeals and grievance regulations and processing
- Bachelor’s Degree required. Master’s preferred
- 5 plus years’ experience in managed care including appeals and grievance and/or compliance
- 2 years’ prior supervisory or management experience required
- Strong knowledge of federal, state and managed healthcare regulations and requirements
- NYS RN License Degree. Strong leadership skills
Job Summary
JOB TYPE
Full Time
SALARY
$102k-130k (estimate)
POST DATE
07/04/2024
EXPIRATION DATE
07/28/2024
WEBSITE
rcmhealthcareservices.com
HEADQUARTERS
St Louis, MO
SIZE
<25
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