Manager, Clinician Appeals

Jobgether • United States

Remote

This Job is No Longer Active This position is no longer accepting applications

AI Summary

Lead and develop clinical appeals teams, oversee quality assurance programs, and drive continuous improvement efforts in a fast-paced healthcare revenue cycle environment.

Key Highlights

Lead clinical appeals teams

Oversee quality assurance programs

Drive continuous improvement efforts

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Key Responsibilities

Lead and develop clinical appeals teams

Oversee hiring, onboarding, coaching, performance management, and ongoing development of domestic and global clinical staff

Establish and maintain quality assurance programs to ensure clinical accuracy, consistency, compliance, and effectiveness of appeal letters

Technical Skills Required

RN, MD, or DO license Payer appeals processes Healthcare regulations Clinical documentation standards Denial management DRG coding CDI best practices Payer denial trends

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Benefits & Perks

Fully remote work environment

Competitive compensation package

Opportunities for professional growth and leadership development

Job Description

This leadership role offers the opportunity to shape and optimize clinical appeals operations within a fast-paced healthcare revenue cycle environment. The position focuses on leading high-performing clinical teams responsible for creating persuasive, compliant, and clinically accurate appeal communications that improve reimbursement outcomes. You will work closely with executive stakeholders, physicians, hospital leaders, and operational teams to drive quality, efficiency, and strategic process improvements. This role combines clinical expertise, operational oversight, and people leadership, making it ideal for a professional who thrives in collaborative and evolving healthcare settings. In addition to managing workflows and quality standards, you will play a key role in mentoring clinicians, improving denial prevention strategies, and supporting client engagement initiatives. The environment is fully remote, mission-driven, and centered on innovation, operational excellence, and measurable impact.

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