Provider Grievance and Appeals Program Manager, Senior

Elevance Health

Full-time - Senior

11-50 employees

Insurance Carriers and Related Activities

About the position

The Grievance and Appeals Program Manager, Senior at Elevance Health is responsible for overseeing Provider Grievances, Provider Appeals, and Provider State Fair Hearings for the Kansas Health Plan. This role involves managing projects and programs that align with business unit and enterprise goals, ensuring effective processes and systems are in place to support these objectives.

Responsibilities

• Manage Provider Grievances, Provider Appeals, and Provider State Fair Hearings for the Kansas Health Plan.
• Identify potential issues, project changes, and scope.
• Lead efforts to identify best practices and impacted parties.
• Develop and design processes and systems that support business needs.
• Design methods for integrating function and process.
• Conduct cost/benefit analyses.
• Build support for business change throughout the business unit.

Requirements

• BA/BS in a related field.
• Minimum of 8 years of process improvement, business change, or project-related experience.

Nice-to-haves

• Experience in developing and managing projects with significant operating budgets.
• Knowledge of process redesign.
• Experience with Member Grievances, Appeals, administrative hearings, or other legal processes.
• Strong oral, written, and interpersonal communication skills.
• Problem-solving, facilitation, and analytical skills.
• Experience as a legal assistant or paralegal.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical benefits
• Dental benefits
• Vision benefits
• Short and long term disability benefits
• 401(k) with matching
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources