Company Statement

Careers at AdvantageCare Physicians: At AdvantageCare Physicians, our providers and care teams reflect our commitment to population health. Improving the health of our patients is our goal; keeping our patients healthy is our commitment. Using our state-of-the-art electronic medical record (EMR) system, our providers, care teams, and practice administration staff work together to deliver high-quality, comprehensive and convenient care to our patients.

 

To protect the health and safety of our workforce, members, patients, and the communities we serve, the EmblemHealth family of companies require all new employees to be fully vaccinated for COVID-19. Exemption/reasonable accommodations may be granted because of 1) a qualifying medical condition or disability that makes getting the vaccine unsafe for the individual, or 2) objection on the basis of sincerely held religious beliefs and/or practices.

Supervisor, Grievance & Appeals

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Manager & Professional
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1000000314 Requisition #
Thanks for your interest in the Supervisor, Grievance & Appeals position. Unfortunately this position has been closed but you can search our 338 open jobs by clicking here.

Education, Training, Licenses, Certifications:
Bachelor’s Degree or additional experience/specialized training may be considered in lieu of educational requirement.


Relevant Work Experience, Knowledge, Skills, and Abilities:

  • 4 – 6+ years of relevant, professional work experience required
  • 1 – 2+ years of managed care experience required
  • Staff/process management experience preferred
  • Knowledge of EmblemHealth’s programs, and of the department’s web-based programs preferred
  • In-depth knowledge of grievance and appeal processes, federal /state regulations, and contractual/processing guidelines required
  • Proficient in MS Office (Word, Excel, PowerPoint, Outlook, Teams, etc.) required
  • Supervisory skills sufficient to direct, motivate, and discipline staff required
  • Analytical and technical ability to review and analyze procedures and workflow and to make recommendations for streamlining the grievance and appeals process within the functional units of the department required
  • Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience required
  • Ability to organize, prioritize, and effectively manage multiple tasks/projects with competing priorities/deadlines required
  • Proven ability to manage a heavy workload in a dynamic, fast paced environment required
  • Ability to problem solve, make appropriate decisions, and seek assistance when necessary required

 

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

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