Lead Director, Appeals and Grievances

Location: Remote - US based candidates only, no visa sponsorship available

About the Role

This role will lead continuous improvement work focused on process discipline, productivity, and measurable operating gains. You will partner with operational leaders and project stakeholders to standardize workflows, identify bottlenecks, and improve execution quality. The position offers the opportunity to create measurable efficiency gains and scalable operational improvements within a healthcare environment.

Responsibilities

• Administer project and process management initiatives ensuring standards adherence
• Advise senior leadership on project strategies for organizational success
• Approve project plans and budgets aligning with organizational priorities
• Foster strategic communication across teams and stakeholders
• Define methodologies to establish best practices for project performance
• Lead data-driven continuous improvement initiatives
• Collaborate with departments to identify areas for operational enhancement

Requirements

• Bachelor's degree required
• 5+ years in appeals and claims operations or related field
• Minimum of 5 years in a leadership role
• 5+ years in project or program management
• Proficiency in data analysis tools like SQL, Tableau, and Excel

Pay

$100,000 – $231,540 annually

Benefits

• Comprehensive medical, dental, and vision coverage
• Paid time off to promote work-life balance
• Retirement savings options
• Wellness programs for physical and emotional support
• Resources for colleagues and their families