Senior Manager, Clinical Appeals & Grievances Operations Lead
Healthfirst
Healthfirst is seeking a Senior Manager, Clinical Appeals & Grievances in the New York area. The role leads daily operations, partners with cross‑functional leaders, and drives continuous improvement in clinical appeals and grievances processing to ensure timely, compliant outcomes. The position requires RN or LPN licensure, a bachelor’s degree or equivalent experience, and experience with utilization management or appeals. Strong leadership and vendor management capabilities are essential. #J-18808-Ljbffr
$122.9k - $188.02k
...The Senior Manager, Clinical Appeals & Grievances provides strategic and operational leadership for the Clinical Appeals & Grievances function, ensuring timely, high-quality... .... This role oversees day-to-day operations, leads internal teams, and partners with cross-...SeniorTemporary workWork experience placementLocal area$174.07k - $374.92k
...Medical Director - Medicare Appeals to join the team of a... ...Medicare appeals operations, with a strong focus on clinical decision-making, regulatory... ...appeal nurses, Utilization Management, Quality, and Compliance... ...to Medicare complaints, grievance, and appeals preferred Health...SuggestedRemote workVisa sponsorshipWeekend work$140k - $160k
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$174.07k - $374.92k
...recognizes physicians for their clinical quality and effective use of... ...role are related to Medicare Appeals: Direct daily work on part C... ...and tracking and Utilization Management Strategy support... ...Management - Medicare Complaints, Grievance & Appeals experience. Health...Hourly payFull timeTemporary workLocal areaRemote workWork from homeWeekend work- ...Nielsen is seeking a Senior Marketing Sales Analyst in New York to own the lead-to-close workflow, design SLAs, and maintain sales reporting. You'll partner with Marketing to close the loop on lead reporting and drive process improvements across U.S. mid-market and global...SeniorWork at office
- ...Essen Healthcare, the largest privately held medical group in New York, is seeking a Clinical Operations Manager to oversee key clinical functions. This role includes managing call centers, lab processes, and ensuring compliance with healthcare standards. The ideal candidate...Senior
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