Appeal Resolution Manager jobs in Dothan, AL

Appeal Resolution Manager manages the grievance process to review, investigate, document, process, negotiate, and resolve disputed medical, insurance, and other claims. Oversees work activity that is compliant with all regulatory guidelines and policy protocols. Being an Appeal Resolution Manager allocates team resources to ensure an effective and balanced case workload. Applies industry standards and uses best practices in the preparation of legal briefs. Additionally, Appeal Resolution Manager may represent the organization at hearings. Requires a bachelor's degree. Typically reports to a senior manager or head of a unit/department. The Appeal Resolution Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be an Appeal Resolution Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Operations Research Systems Analyst
  • Strategic Resolution Experts, Inc.
  • Fort Rucker, AL FULL_TIME
  • Must be US Citizen with active Secret Clearance

    Do you want to perform work that is impactful to millions of Americans and has a broader global impact?

    Are you service minded team player who works towards creating solutions for the greater good?

    We Empower You to Serve!

    SRE delivers Organizational Transformation Services to the federal Government through Strategy, People, Leadership Development, Coaching, Facilitation, and Organizational Change Management. We underpin this with Project Management, business process improvement, and use technology as an enabler.

    Our mission is to serve our country, our communities, and our employees. Our vision is to make a positive impact on the world by leaving it better off when we leave than when we came. We are seeking professional consultants who share in our mission of service, our vision of leaving the world a better place, and are committed to our values of Integrity, Quality, and Performance.

    After reviewing the position description, if you feel you are a fit for our organization and possess the required qualifications, we invite you to apply:

    As an Operations and Strategy Research Consultant specializing in U.S. Army Aviation, your role involves leveraging ORSA expertise to address aviation-specific challenges and optimize Aviation operations. You will work closely with US Army Aviation Unit Commanders, and their staff, to enhance aviation readiness, effectiveness, and safety.

    The consultant isolates and defines unknown conditions, resolves critical problems or develops new theories. The work results affect the work of other experts, the development of major aspects of administrative or scientific programs or missions, or the well-being of substantial numbers of people.

    The consultant regularly meets with analysts and specialists within the organization, other staff elements, or with professionals and program directors in other DOD elements and across the Aviation Enterprise to summarize, interpret, and exchange information on issues, to present and defend results of work, and to negotiate with groups and individuals holding differing goals/viewpoints. Must be able to gain stakeholder buy-in, build consensus, and create inclusive solutions to resistance encountered due to organizational conflict, competing objectives, or resource issues.

    The consultant receives general supervision from a project manager, who provides project assignments without explicit technical supervision. Consultant must independently transform high level guidance into specific solutions and tasks which are performed to completion. Performs duties and responsibilities with a high degree of professionalism, independence, and technical authority. Keeps project manager and customer informed as to the status of studies and technical decisions which may alter critical stages of studies, may impact policy or precedent, or may be controversial in some other manner. Supervisory review of work is for timeliness, satisfactory compliance with overall policy, attainment of program objectives, and overall feasibility of recommendations.

    Major Duties:

    Serves as senior consultant engaged in the research and evaluation of current and future U.S. Army Aviation organizations and operations in support of the USAACE G5 and is accountable for the products of all work completed.

    1. Receives broad guidance or fragmentary information on the proposed study efforts; determines study's purpose and objectives, plans and recommends courses of action, derives and employs methodologies and techniques for solving problems, organizes study teams, and coordinates execution of the study. Monitors progress of all phases of assigned studies to include support requirements such as computer scheduling, administrative support, liaison among external agencies, and assembly of data banks. Coordinates activities of personnel external to the organization who support and contribute to major studies, such as technical support, other contractor teams, scenario development teams, combat modeling teams, and U.S. Army Materiel Command analysts and engineers. Verifies the study results and conclusions. Prepares study plans, technical reports, briefings, and other documentation.

    2. Organizes and presents study results, findings, conclusions, options, and recommendations to the USAACE G5, USAACE CG, General Officer level higher commands, and other government agencies, and organizations across the Aviation Enterprise. Attends meetings and conferences and submits study results, findings, conclusions, options, and recommendations regarding current status of Aviation Operations and future strategy and strategic direction for the force. Obtains information and reports on recent changes in the field that may impact the U.S. Army Aviation mission.

    3. Conducts operations research studies involving many and varied aspects of U.S. Army Aviation tactical and operational matters within the sphere of responsibility of the U.S. Army Aviation Center of Excellence and Aviation School. Initiates and carries to completion, highly specialized and technical research studies involving mathematical analysis, design of experiments, sampling, and other statistical techniques. Develops the analysis and evaluation using mathematical models to arrive at facts and data on such things as tactics, force development, combat operations, materiel readiness, and combat development of Aircraft and Aviation support systems. Assists in the coordination and participates in simulation operations and exercises to test future doctrine and organizational concepts for Army Aviation. Applies a thorough knowledge of operations research, computer simulation languages, and leadership skills.

    1. Applies knowledge of current developments in operations research and computer simulation applications. Maintains close liaison with other Aviation Enterprise elements and external agencies to include but not limited to CAC; TRADOC; FORSCOM, PACOM; HQDA, other DOD and U.S. Government agencies, and Original Equipment Manufacturers (OEMs); to obtain current and future state-of-the art achievements in Aviation equipment and derivative doctrine. Reviews technology reports and conducts technology application studies in scientific fields related to the Aviation mission. Advises the USAACE G5 regarding new techniques, innovations and technical and scientific advancements which may serve as a means of overcoming tactical and operational problems. Applies a high degree of knowledge concerning current and potential threat to the field Army with significant emphasis on the air threat.
    2. Performs other duties as assigned.

    Work experience in Military Aviation operations is required.

    Knowledge Required by the Position:

    • Mastery of one or more specialized areas of operations research sufficient to apply new analytical developments, methodologies, and research findings to broad studies of an unprecedented nature.
    • Mastery of research techniques and concomitant ability to obtain information concerning subject studies so as to be able to perform sound analyses.
    • Skill in coordinating extensive projects in assigned areas of responsibility. Projects are characterized by high visibility, unusual urgency, or program criticality.
    • Ability to use advanced techniques and the modification and extension of theories, precepts and practices of operations research, and related sciences and disciplines.
    • Ability to establish and maintain effective relationships with customers, information sources, and project team members
    • Skill in written and oral communication sufficient to present information on the scope, methods and results of studies.
    • Expert knowledge of composition, workings, and characteristics, of major weapons systems and relationships to other weapons systems, associated military tactics, operations, strategies, and logistics considerations.
    • Expert knowledge of complex subjects under study so that conclusions reflect real world environments.
    • Ability to organize and support teams engaged in studies of complex issues and problems.
    • Skill in articulating and negotiating very complex and sensitive issues with officials of diverse perspectives and with different, sometimes opposing, viewpoints.
    • Expert knowledge of a full range of cost and economic analyses techniques.

    Complexity:

    Assigned projects may or may not have technical precedents or guidelines available, and if available, may only provide foundation for departure. The consultant develops or redesigns new methods, approaches, or criteria to meet the demands of the specific assignment.

    The consultant performs complete assignments, individually or as a member of a team, which are characterized by substantial breadth or depth, numerous interrelationships, complex variables, and new theories and methodologies. The problems studied typically are unique in nature and difficult to define. Often a study must be approached in phases, requiring the analyst to coordinate the contributions of others. A thorough understanding of the substantive areas of problems studied is required, as well as competence in scientific analytical techniques. Originality and creativity are required to adapt, extend, and synthesize existing theories and techniques for unrelated purposes, or to isolate and define critical features of long-range problems. Widely different views are often held on what the issues are, on relevant economic factors and forecasts, appropriate study techniques and approaches, and on best courses of action. In-depth analyses and extensive coordination and intensive negotiations with different high officials are required to resolve issues.

    Education:

    • BA/BS degree required
    • MA/MS degree desired
    • Lean Six Sigma Certification desired


    SRE, Inc. is an equal opportunity employer and does not discriminate against any employee or applicant for employment bcause of race, color, religion, sex/gender or gender identity, national origin, veteran status, sexual orientation, or marital status.


     

  • 17 Days Ago

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Aviation Subject Matter Expert (SME), Army G5
  • Strategic Resolution Experts, Inc.
  • Fort Rucker, AL FULL_TIME
  • Must be US Citizen with active Secret Clearance Do you want to perform work that is impactful to millions of Americans and has a broader global impact? Are you service service-minded team player who w...
  • 19 Days Ago

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Issue Resolution Specialist / Account Coordinator Hybrid
  • DEEP MILE NETWORKS
  • Fort Novosel, AL FULL_TIME
  • ABOUT DEEP MILE NETWORKS, LLC:Deep Mile Networks, LLC (“Deep Mile”) is a premier provider of training and technology solutions and management consulting services since 2006. The Company’s industry bes...
  • 30 Days Ago

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Manager
  • Arby's
  • Dothan, AL FULL_TIME,PART_TIME
  • ```Job Overview:```We are seeking a highly motivated and experienced Manager to join our team. As a Manager, you will be responsible for overseeing the daily operations of our restaurant and ensuring ...
  • 1 Month Ago

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Manager
  • Wendy's
  • Ozark, AL FULL_TIME
  • Want to make a difference? Want to be a leader?The General Manager manages the operations and staff of a Wendy’s restaurant, including the execution of all Company policies, procedures, programs and s...
  • 27 Days Ago

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Manager
  • Popeyes CK Management
  • Geneva, AL FULL_TIME
  • Popeye’s Louisiana Kitchen – Manager Position Description Our Popeye’s franchise is seeking customer service and results oriented Managers to join our team. Do you possess great customer service, lead...
  • 1 Month Ago

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0 Appeal Resolution Manager jobs found in Dothan, AL area

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LPN, Home Health Per Diem
  • CenterWell Home Health
  • Dothan, AL
  • Become a part of our caring community and help us put health first As a Home Health LPN, you will: Provide professional ...
  • 4/25/2024 12:00:00 AM

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Operations Manager (Medicaid Eligibility)
  • Elevate Patient Financial Solution
  • Dothan, AL
  • Elevate Patient Financial Solutions has an exciting career opportunity available as an Operations Manager I. This positi...
  • 4/25/2024 12:00:00 AM

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FT Customer Support Specialist - Work From Home>
  • Stronghold
  • Enterprise, AL
  • [Customer Service / Fully Remote] - Anywhere in U.S. / Competitive Pay / Email Only - As a Customer Support Specialist y...
  • 4/25/2024 12:00:00 AM

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Picker / Packer
  • Walmart
  • Dothan, AL
  • **Job Title: Picker/Packer** **Job Summary:** As a Picker/Packer at Walmart, you will play a critical role in the fulfil...
  • 4/24/2024 12:00:00 AM

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FT Customer Service Representative - Work From Home>
  • House of Rohl
  • Dothan, AL
  • [Call Center / Fully Remote] - Anywhere in U.S. / Up to $42K per year / Benefits - As a Customer Service Rep you'll: Han...
  • 4/24/2024 12:00:00 AM

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Full-Time Assistant Store Manager
  • Aldi
  • Enterprise, AL
  • When you join our team as an Assistant Store Manager, youll take on key store management responsibilities including assi...
  • 4/23/2024 12:00:00 AM

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RN Case Manager Home Health Full Time
  • CenterWell Home Health
  • Enterprise, AL
  • Become a part of our caring community and help us put health first As a Home Health RN Case Manager, you will: Provide a...
  • 4/22/2024 12:00:00 AM

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Baylor RN, Home Health Full Time
  • CenterWell Home Health
  • Dothan, AL
  • Become a part of our caring community and help us put health first As a Home Health Registered Nurse, you will: Provide ...
  • 4/21/2024 12:00:00 AM

Dothan /ˈdoʊθən/ is a city in Dale, Henry, and Houston counties in the U.S. state of Alabama. It is the county seat of Houston County and the seventh largest city in Alabama, with a population of 65,496 at the 2010 census. It is near the state's southeastern corner, approximately 20 miles (32 km) west of the Georgia state line and 16 miles (26 km) north of Florida. It is named after the biblical city, the place where Joseph's brothers threw him into a cistern and sold him into slavery in Egypt. Dothan is the principal city of the Dothan, Alabama metropolitan area, which encompasses all of Gene...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Manager jobs
$80,458 to $104,565
Dothan, Alabama area prices
were up 1.3% from a year ago

Appeal Resolution Manager in Racine, WI
General provisions on appeals are contained within CPR PD 52A.
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Appeal Resolution Manager in Lancaster, PA
All appeals must be submitted in writing to the RC within ten academic calendar days after notification of the Dean of Students’ decision to accept or modify the recommendations resulting from the hearing.
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Appeal Resolution Manager in San Diego, CA
The Coalition recommended that its members consider resolutions to request the Commission on Marine Resources to go forward with scientific and engineering studies regarding the Pearl River water resource project and creation of the Western Sound Special Management District.
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