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Appeals Supervisor - West Sacramento, CA (On-site)

Gainwell Technologies LLC
West Sacramento, CA Full Time
POSTED ON 12/21/2024
AVAILABLE BEFORE 2/18/2025

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.


Summary

As an Appeals Supervisor at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions. Here are the details on this position.

Your role in our mission

  • Supervises team in adjudicating provider Appeal claims ensuring that target service level agreements are met.
  • Analyzes appeals and provide recommendations on how to reduce the number of provider appeals.
  • Develop staff to respond to current and anticipated needs of department as well as determining career development goals of individuals.
  • Recommends approved modifications and/or new processes to maintain competitiveness in the industry. Identifies additional product/services opportunities in client organization and follows up with business development team.
  • Recommends and/or initiates the selection and hiring of employees. Trains and evaluates employees to enhance their performance, development, and work product. Addresses performance issues and makes recommendations for personnel actions. Makes recommendations for salary increases transfers and terminations to manager.

What we're looking for

  • Bachelor's degree or equivalent combination of education and experience
  • Three or more years Healthcare Claims experience
  • Six or more years of leadership experience
  • Experience working with business processes, and associated information technology applications
  • Experience working with application delivery, management structures and reporting procedures

What you should expect in this role

  • Position is 100% on-site in West Sacramento
  • 7am – 4pm PST zone
  • Leadership and organizational skills
  • Good interpersonal skills to interact with customers and team members
  • Communication skills, engagement as part of a larger team
  • Human relations skills to select, develop, mentor, discipline, and reward employees
  • Ability to develop and apply business and management consulting applications and services


#LI-ONSITE

#LI-CB1


The pay range for this position is $54,200.00 - $77,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.


We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.


Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

Salary : $54,200 - $77,400

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