Director, Grievances & Appeals - Remote FL

Centene Corp.; Florida; Remote; USD 108,000 - 199,000; Full time

Job summary

Centene Corp. is seeking a Director of Grievance & Appeals to oversee the member appeals and grievance processes from a Florida-based, remote location. The role emphasizes efficient operations, regulatory compliance, and continual improvement across cross-functional teams.

Requires 5+ years in grievances/appeals/healthcare law and prior management experience in managed care. The position offers a salary range of $107,700.00 to $199,300.00 per year, with state residency required in Florida.

Qualifications

• Bachelor's Degree in a related field or equivalent experience.
• Master's Degree preferred.
• 5+ years of experience in grievances, appeals, or healthcare law related fields.
• Previous management experience in managed care operations and leading cross-functional teams.

Responsibilities

• Oversee and direct the appeals and grievance processes for members.
• Lead and improve execution, outcomes, and performance metrics across the department.
• Participate on internal committees to assess risk and regulatory impact; develop compliant processes and trainings.
• Represent the health plan in legal settings when needed and coordinate with plan attorneys.

Skills

Grievance management

Healthcare law

Staff management

Cross-functional leadership

Education

Bachelor's degree or equivalent

Master's degree preferred

Job description

Centene Corp. is seeking a Director of Grievance & Appeals to oversee the member appeals and grievance processes from a Florida-based, remote location. The role emphasizes efficient operations, regulatory compliance, and continual improvement across cross-functional teams.

Requires 5+ years in grievances/appeals/healthcare law and prior management experience in managed care. The position offers a salary range of $107,700.00 to $199,300.00 per year, with state residency required in Florida.