Appeals Clinical Team Lead
PacificSource Health Plans(1 month ago)
About this role
The position is a managerial clinical role responsible for overseeing appeals clinical staff within PacificSource to support members’ access to quality, affordable care. The role involves ensuring program development and implementation, maintaining clinical and regulatory standards across appeals and grievance processes, and collaborating across departments to improve outcomes and processes.
Required Skills
- Accountable Leadership
- Supervision
- Appeals Management
- Utilization Management
- Case Management
- Process Improvement
- Lean Methodologies
- Communication
- Critical Thinking
- Decision Making
+2 more
Qualifications
- Registered Nurse License
- Licensed Social Worker License
- Current Unrestricted State License
- Multi-State Licensure (within 6 months)
About PacificSource Health Plans
pacificsource.comPacificSource offers health insurance plans for individuals, families, and employers. A Northwest not-for-profit, we put members first.
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