Hybrid Appeals & Grievances Manager

BCBSM, Inc.

Eagan (MN)

Hybrid

USD 102,000 - 174,000

Full time

6 days ago

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Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

401k

PTO

Volunteer PTO

Job summary

Blue Cross and Blue Shield of Minnesota seeks an experienced Corporate Appeals Manager to lead escalation and corporate appeal processes, driving continuous improvement and regulatory compliance. You will collaborate with audits, legal, and external providers while guiding teams through complex issues.

Hybrid role based in Eagan, MN with collaboration two days per week. The position offers competitive benefits and a clear path to impact, with accountability for timely, thorough, and compliant

Qualifications

5+ years of progressive customer service/operations experience with leadership or project lead responsibilities.
Bachelor’s degree; in lieu of a degree, two additional years of relevant experience may be accepted.

Responsibilities

Identify and analyze appeal trends, drive improvements, and ensure regulatory compliance.
Own the escalated corporate appeal process and collaborate with legal, medical, and provider stakeholders.
Lead cross-functional workgroups and coordinate vendor relationships to improve workflows.
Implement new technical solutions to enhance efficiency and audit readiness.
Provide strategic direction and manage resources to meet corporate objectives.

Skills

Customer service

Team leadership

Education

Bachelor’s degree

Masters preferred

Job description

Hybrid role based in Eagan, MN with collaboration two days per week. The position offers competitive benefits and a clear path to impact, with accountability for timely, thorough, and compliant

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