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Appeals And Grievances Manager
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- Managing the grievance and appeals team which includes reporting, training, enforcement and auditing of internal procedures, controls, and issues.
- Demonstrate understanding of the appeals and grievance processes, including all regulatory and reporting requirements.
- Manage all grievance and appeals related reports.
- Serve as the Subject Matter Expert (SME) for grievance & appeals processes and casework.
- Ensure casework is classified appropriately in the Grievance & Appeals system (Inovaare) to support accurate data extraction of CMS, NCQA, and leadership reporting deliverables.
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