Healthcare Appeals & Projects Lead

CVS Health; Atlanta (GA); Vor Ort; USD 54.000 - 159.000; Vollzeit

Zusammenfassung

CVS Health in Atlanta is seeking a seasoned leader to build and maintain a high-performing Appeals team. You will train, coach and develop staff, ensure quality and accuracy in universe data validations, and present project findings in team meetings.

You will establish consistent processes with the business to keep appeals compliant with regulatory and accreditation requirements, identify developmental needs, drive action plans, manage multiple projects, and report audit-ready capabilities.

Qualifikationen

• 3+ years Appeals background.
• Microsoft Office experience.
• Knowledge of Appeals job aids/workflows.
• Strong Communication skills - ability to provide and receive feedback.
• Excellent time management skills.
• 2+ years of supervisory experience.
• Ability to work collaboratively across teams.
• Strong analytical skills focusing on accuracy and attention to details.

Aufgaben

• Build and maintain a solid team through training, coaching and developing staff.
• Validate effectiveness of the different projects managed by appeals team through universe data validation.
• Facilitate and present at meetings within the Appeals team.
• Establish and maintain in collaboration with the business, consistent processes defining the overview and readiness of appeals to help remain compliant with regulatory and accreditation requirements.
• Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams and individuals.
• Manage projects and identify trends and recommends/acts on solutions.
• Report capabilities related to audit requests and universe submissions.

Kenntnisse

Appeals background

Leadership

Project management

Communication

Time management

Analytical thinking

Ausbildung

High school diploma or higher education

Bachelor's degree or equivalent experience

Tools

Microsoft Office

QuickBase

CMS guidance

Jobbeschreibung

CVS Health in Atlanta is seeking a seasoned leader to build and maintain a high-performing Appeals team. You will train, coach and develop staff, ensure quality and accuracy in universe data validations, and present project findings in team meetings.

You will establish consistent processes with the business to keep appeals compliant with regulatory and accreditation requirements, identify developmental needs, drive action plans, manage multiple projects, and report audit-ready capabilities.