“Making Healthcare Right. Together.” is the cornerstone of all we do. Our vision is through powerful relationships with Care Partners, we help all people live healthy and brighter lives. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright employees to embody and uphold our core values in work and interactions, both internal and external: be brave, be brilliant, be accountable, be inclusive, and be collaborative.

ABOUT THE ROLE

The Appeals and Grievances Team (A&G) Supervisor is responsible for providing exceptional & dedicated support to the Appeals and Grievances Team, while demonstrating & incorporating the Bright values into day to day operations. 

YOUR RESPONSIBILITIES

• Monitors all incoming appeal channels(fax, phone, email), and routes work to team members; ensures that cases are completed within turnaround times
• Oversees A&G Team in completing casework, including performance improvement, coaching and development in accordance with Bright standards
• Participates in and/or leads audits, partners with analytics, compliance to analyze and finalize data sets, be presenter at audit, responder to inquiries
• Develop and deliver needed training on systems and processes, perform Desk Level Procedures (DLP) development and maintenance, lead regular team meetings and 1:1s
• Analyze and report daily/weekly/monthly performance metrics and issue trends

SUPERVISORY RESPONSIBILITIES

• This position has supervisory responsibilities

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• High School diploma or GED required; Bachelor’s degree preferred
• Five (5) or more years of experience in Health Plan Appeals & Grievances or Customer Service required Two + years of leadership experience preferred
• Call monitoring and QA mentoring experience preferred but not required
• Experience with Performance Improvement Plans or similar required
• Experience with classroom and/or individual training sessions required 

PROFESSIONAL COMPETENCIES

• Strong communication skills, both verbal and written
• Organized and able to prioritize work to meet deadlines
• Works independently with little supervision
• Able to thrive in an often-chaotic environment
• Understands regulatory compliance within the healthcare industry
• Able to work independently with little supervision
• Able to thrive in an often-chaotic environment

WORK ENVIRONMENT

• Most work responsibilities are performed in an open office setting, carrying out detailed work sitting or standing at a desk/table and working on the computer
• Some travel may be required (may be altered during pandemic)
• Live by the Bright values to maintain a strong, collaborative culture 

ABOUT US

At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.

We’re Making Healthcare Right. Together. 

We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!