Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
Supervisor, Grievance & Appeals
Qualifications:
- Bachelor’s Degree
- 4 – 6+ years of relevant, professional work experience (Required)
- 1 – 2+ years of managed care experience (Required)
- Staff/process management experience (Preferred)
- Additional experience/specialized training may be considered in lieu of educational requirement (Required)
- Knowledge of EmblemHealth’s programs, and of the department’s web-based programs (Preferred)
- In-depth knowledge of grievance and appeal processes, federal /state regulations, and contractual/processing guidelines (Required)
- Proficient in MS Office (Word, Excel, PowerPoint, Outlook, Teams, etc.) (Required)
- Supervisory skills sufficient to direct, motivate, and discipline staff (Required)
- Analytical and technical ability to review and analyze procedures and workflow and to make recommendations for streamlining the grievance and appeals process within the functional units of the department (Required)
- Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience (Required)
- Ability to organize, prioritize, and effectively manage multiple tasks/projects with competing priorities/deadlines (Required)
- Proven ability to manage a heavy workload in a dynamic, fast paced environment (Required)
- Ability to problem solve, make appropriate decisions, and seek assistance when necessary (Required)
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.