Healthcare Appeals Manager: Compliance, Strategy & Ops

Prominence Health Plan

Prominence Health Plan in Reno, NV seeks a Manager, Appeals to oversee the Appeals Department within a value-based care organization. You will ensure timely, compliant adjudication across Commercial, Self-Funded, and Medicare Advantage lines, and drive continuous improvement in outcomes and audit readiness.

Lead cross-functional collaboration with Medical Directors, Compliance, Legal, and Claims Ops to optimize processes, report metrics, and develop training for staff.

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Vacancy posted 3 days ago

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