Supervisor, Operations (Non-Clinical AGD)

Your Role

The Commercial Appeals & Grievances department performs comprehensive research related to the facts and circumstances of member complaints, appeals, and grievances. The department partners with the customer service and operations teams to ensure alignment with service levels to provide service worthy of our family and friends. The Commercial Appeals & Grievances Supervisor will report to the Commercial Appeals & Grievances Senior Manager. In this role, you will be accountable for hiring, promoting, coaching and daily supervision of Commercial Appeals & Grievances coordinators as they review, investigate, and process member appeals and grievances in a manner that is consistent with regulatory requirements and department policies and procedures. You will manage projects and participate in regulatory audit activities.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires High School Diploma or GED
• Requires a minimum of 5 years of prior relevant experience
• Requires related experience and/or training, or equivalent combination of education and experience. Must have experience in appeals and grievances and preferred experience in claims, customer service, installation & billing, or member services role in the health care industry.
• Understands basic supervision/management approaches such as work scheduling, prioritizing, coaching and process execution
• Requires broad knowledge of technical or operational practices within assigned discipline
• Commercial experience preferred
• Must be willing to work weekends and holidays as needed

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.