Delivery Senior Manager
About The Position
Requires Bachelor's degree 8 years of health plan appeals experience, specifically in clinical appeals Deep understanding of Medicare policies, coverage guidelines, and appeals process Strong clinical knowledge and ability to interpret medical records, documenting recommendations to uphold or overturn denials Excellent analytical and problem-solving skills Strong communication and presentation to interact with diverse stakeholders at various organization levels Leadership experience in managing a team and achieving results Experience with healthcare regulations and compliance requirements Ready to Travel upto 25%. Presentation and communication experience, creating decks to convey topics including status, value, processes Advanced organizing and planning skills to oversee project deliverables. Advanced priority setting and delegation skills. Advanced analytical, problem solving, negotiation and communication skills To work remote, individuals must meet all the established Remote requirements including those pertaining to a home workspace and related technology. Technology Employees are responsible for the care and security of all equipment provided. They must return it immediately upon separation from the company following company protocols. Failure to return equipment may result in collection actions and/or other consequences. Individuals must provide their own high speed internet access with speeds at or above 50 Mbps. A hard-wired ethernet connection is required. Wi-Fi, mobile, wireless and public internet connections are forbidden as are connections outside of one's personal dwelling or location. Management monitors all technical issues and agent downtime.
Requirements
- Bachelor's degree
- 8 years of health plan appeals experience, specifically in clinical appeals
- Deep understanding of Medicare policies, coverage guidelines, and appeals process
- Strong clinical knowledge and ability to interpret medical records, documenting recommendations to uphold or overturn denials
- Excellent analytical and problem-solving skills
- Strong communication and presentation to interact with diverse stakeholders at various organization levels
- Leadership experience in managing a team and achieving results
- Experience with healthcare regulations and compliance requirements
- Ready to Travel upto 25%
- Presentation and communication experience, creating decks to convey topics including status, value, processes
- Advanced organizing and planning skills to oversee project deliverables
- Advanced priority setting and delegation skills
- Advanced analytical, problem solving, negotiation and communication skills
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Number of Employees
5,001-10,000 employees
