Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
SummaryThe
Appeals Supervisor is responsible for overseeing daily operations of appeals adjudication activities, ensuring timely, accurate provider response. This role provides direct leadership to appeals staff, serves as an operational liaison to clients and internal stakeholders, and drives performance through standard performance management, process improvement, and workforce coaching. The ideal candidate brings strong healthcare operations experience, proven people leadership, and the ability to manage performance in a client-facing, metric drive environment.
Your role in our mission - Oversee day-to-day provider appeal adjudication operations.
- Analyzes appeals and provides recommendations on how to reduce the number of provider appeals.
- Ensure adherence to standard operating procedures (SOPs), regulatory requirements, service level agreements (SLAs), and clint-specific performance standards.
- Lead, coach, and develop a team of Appeals Examiners, and Appeals support staff, supporting performance management and training.
- Monitor operational performance, including productivity, accuracy, turnaround times, and backlog levels, and implement action plans to drive improvement.
What we're looking for - 3-5+ years of experience in healthcare operations, claims/appeals processing, provider services, or Medicaid-related functions.
- 5+ years of supervisor or people leadership experience.
- Experience managing performance metrics, including KPIs, SLAs, productivity, and quality standards
- Strong analytical skills with the ability to interpret data, identify trends, and drive process improvements.
- Excellent communication and interpersonal skills with the ability to engage effectively in a client-facing environment.
- Ability to manage multiple priorities, meet deadlines, and operate effectively in a fast-paced, high-volume environment.
What you should expect in this role - Lead and develop a team of Appeals Examiners and support staff in a fast-paced, high-volume healthcare operations environment.
- Monitor and drive performance related to productivity, quality, turnaround times, service level agreements (SLAs), and operational goals.
- Collaborate with clients, providers, and internal stakeholders to resolve issues and ensure exceptional service delivery.
- Analyze operational data, identify trends, and implement process improvements to enhance efficiency and reduce provider appeals.
- Work on-site in West Sacramento, California, Monday through Friday from 7:00 AM to 4:00 PM, while supporting a culture of accountability, continuous improvement, and employee development.
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The pay range for this position is $78,000 - $111,400 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
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