Weekend Appeals & Grievances Inventory Manager

Healthfirst; Tennessee; On-site; USD 89,000 - 132,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Incentive programs

Life insurance

401k

Job summary

Healthfirst is seeking a Weekend Inventory Manager to oversee Appeals & Grievances teams, coordinating weekend assignments, routing expedites, and ensuring regulatory compliance. You will monitor inventory, partner with medical reviewers, and maintain vendor relationships to support timely appeals processing.

The role requires strong communication, independent work ethic, and weekend availability, with a focus on quality and adherence to HIPAA guidelines across the enterprise.

Qualifications

• Experience in appeals and grievances or healthcare environment.
• Strong verbal and written communication skills.
• Ability to work independently in a fast-paced setting with multiple priorities.
• Willing to work weekend schedule (Fri-Mon or Thurs-Sun).
• Experience with care management systems like CCMS, TruCare and Hyland.

Responsibilities

• Prepare and plan the weekend staff's assignments to ensure compliance.
• Triage and assign expedited appeals and optimize routing.
• Manage inventory to ensure regulatory compliance for weekend appeals.
• Coordinate with outside departments for escalation and collaboration.
• Maintain vendor relationships and ensure performance and compliance.
• Review Level 2 appeals packets and submit appropriately.
• Adhere to HIPAA and protect confidential information.
• Comply with state and federal guidelines.

Skills

Verbal communication

Written communication

Independent worker

Multitasking

Weekend availability

Education

HS Diploma or GED

Bachelor's degree (preferred)

Tools

Microsoft Word

Excel

Corporate email systems

Macess

CCMS

TruCare

Hyland

Job description

Healthfirst is seeking a Weekend Inventory Manager to oversee Appeals & Grievances teams, coordinating weekend assignments, routing expedites, and ensuring regulatory compliance. You will monitor inventory, partner with medical reviewers, and maintain vendor relationships to support timely appeals processing.

The role requires strong communication, independent work ethic, and weekend availability, with a focus on quality and adherence to HIPAA guidelines across the enterprise.