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Manager GAU - Registered Nurse (RN)
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$80,100 - $120,200
- Manager GAU - Registered Nurse (RN) Blue Cross & Blue Shield of Rhode Island, 500 Exchange Street, Providence, Rhode Island, United States of America Req #1973 Monday, July 8, 2024 Please email if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
- Why this job matters:Manage the daily work of administrative grievance and appeals staff to ensure adherence to quality standards, deadlines, and proper procedures.
- Ensure operations are consistent with state and federal guidelines for all products, including Centers for Medicare and Medicaid Services (CMS), RI Department of Health (DOH), US Department of Labor (DOL), Patient Protection & Affordable Care Act and NCQA and Blue Cross Blue Shield Association requirements.
- What you will do: Coordinate the workflow and operations of two units within the grievance and appeals department, commercial and Government Programs.
- Ensure adherence to regulatory, accreditation, BCBS Association and corporate timelines and quality standards.
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