Appeals Operations Supervisor - Hybrid (Flint, MI)

McLaren; Flint (MI); Hybrid; USD 65,000 - 95,000; Full time

Job summary

McLaren Health Plan seeks a Supervisor, Appeals to lead the appeals and grievances team and ensure compliance with State and NCQA regulations. You will develop procedures, monitor performance, and coordinate training to improve efficiencies across the department.

The role requires on-site presence in Flint, MI on a hybrid schedule. Prior supervisory experience in managed care is preferred to drive quality service for members and regulators.

Qualifications

• Associate degree or higher in business or health care with related experience.
• Two years of experience in an HMO/Managed Care operations role.
• Supervisory experience preferred for larger staff.

Responsibilities

• Provide overall supervision to appeals and grievances operations.
• Ensure compliance with State and NCQA Appeals regulations.
• Develop policies and procedures for Appeals Department.
• Create training programs and monitor staff performance.
• Implement workflows to improve department efficiency.

Skills

Supervisory experience

Staff training

Regulatory compliance

Education

Associate degree in business/health care

High school diploma with 2 years related experience

Bachelor's degree in business/health care

Job description

McLaren Health Plan seeks a Supervisor, Appeals to lead the appeals and grievances team and ensure compliance with State and NCQA regulations. You will develop procedures, monitor performance, and coordinate training to improve efficiencies across the department.

The role requires on-site presence in Flint, MI on a hybrid schedule. Prior supervisory experience in managed care is preferred to drive quality service for members and regulators.