Grievances, Appeals, and Disputes ManagerSteward Health Care - Phoenix, AZ
Grievances, Appeals, and Disputes Manager','1706057','!*!The Grievance, Appeals, and Disputes Manager is responsible for the management and coordination of all activities within the Quality department with focus on Grievances, Appeals, and Disputes. The position is responsible for the development, implementation, and ongoing management of Health Choice's overall Grievance, Appeals, and Disputes Programs under the direction of the Vice President of Quality. This position has oversight responsibilities for the quality of providers' service delivery in addition to satisfaction of providers and members.
This role is expected to communicate job expectations to staff; plan, assign, monitor, and appraise employee's job results; develop, implement, and enforce policies and procedures; collaborate with other departments to ensure provider and member satisfaction; and maintain, train, orient, mentor, and evaluate staff.
The ideal candidate would have extensive experience in Medicare / Medicaid / an ACO / a health plan. A registered nurse is also preferred. Management experience (as a lead, supervisor, or manager) strongly preferred.
Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment – while still being valued for your individual strengths – Health Choice is the place for you.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled ','!*!Qualifications:
A Registered Nurse in the state of Arizona is preferred, but not required
Three (3) years of clinical nursing experience preferred
Two (2) years of QA/QM experience
One (1) year HMO or related healthcare delivery system; QM experience preferred
Two (2) years of management experience
Access database and Excel spreadsheet knowledge
Basic knowledge of statistics and data analysis skills
Ability to prioritize
Capable of project management','Office Manager','Arizona-Phoenix','','Health Choice','High School Diploma/GED','','Full Time Benefit Eligible 36-40 hrs/wk','Full Time Benefit Eligible 36-40 hrs/wk','Days','Days','Grievances, Appeals, and Disputes Manager
Steward Health Care
applyGrievances, Appeals, and Disputes Manager Steward Health Care - Phoenix, AZ, United States
Steward Health Care System is a community-based accountable care organization and community hospital network with more than 17,000 employees serving more than one million patients annually in more than 150 communities. Each hospital and facility within the Steward family, while part of an extensive network of health care providers, has its own rich history of providing outstanding, compassionate care right in the communities where patients need it most. Hospitals in the system include Carney Hospital in Dorchester, Good Samaritan Medical Center in Brockton, Holy Family Hospital in Methuen, Merrimack Valley Hospital in Haverhill, Morton Hospital in Taunton, Nashoba Valley Medical Center in Ayer, New England Sinai Hospital in Stoughton, Norwood Hospital, Quincy Medical Center, Saint Anne’s Hospital in Fall River and St. Elizabeth’s Medical Center in Brighton.
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