Appeal Resolution Manager jobs in Great Falls, MT

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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Manager
  • Central Montana Medical Center
  • Lewistown, MT FULL_TIME
  • Provides supervision and oversight to the Purchasing, Environmental Services, and Laundry
    housekeeping/laundry/purchasing activities. Performs in accordance with established policies and
    procedures of Central Montana Medical Center.

    Continued employment and raises in this position are dependent upon Central Montana
    Medical Center's fiscal viability and: •

    Actions and communications that contribute to a team concept and create a
    positive environment for all customers •

    Acceptable performance of essential and all job duties •

    Acceptable attendance record •

    Accountability for safety to self, patients, visitors and all customers, and care of
    equipment and building •

    Adherence to departmental and facility policies and procedures, education
    requirements, compliance monitoring and reporting, and CMMC Code of
    Conduct •
    Accountability for the consequences of own actions •

    Physical and emotional ability to perform essential functions •

    Acceptable background investigation results if required for position

    Minimum Education, Experience, Licensure, Certification required:

    Minimum: High school diploma, two years related experience, computerized Materials
    Management system experience, or equivalent combination of education and experience.
    Preferred: Bachelor’s degree from four-year college or university in business or related field.

    ESSENTIAL FUNCTIONS/DUTIES:
    (Must be able to perform with or without accommodation)

    1 Supports and demonstrates Central Montana Medical Center’s Vision, Mission and Values
    Statements.

    2 Responsible for overall operation of Purchasing/Laundry/Environmental Services

    3 Maintains and establishes departmental policies, procedures, objectives, quality assurance
    program, safety, environmental and infection control standards.

    4 Completes employee evaluations on time, offers guidance for professional growth when/where
    appropriate. Conducts investigation and institutes disciplinary actions in collaboration with
    Human Resources.

    5 Provide supervision and training for personnel.

    6 Develops and demonstrates effective communication tools to disseminate information and to
    interact with department’s and organization’s staff. Initiate and runs meetings as required.

    7 Participates in meetings and events as required or requested.

    8 Completes required productivity reports in a timely manner.

    9 Administer and direct procurement system for all equipment and supplies, consistent with high
    quality and economy. Responsible for equipment purchase authorizations.

    10 Develop specifications for routinely used items and specifications for specialized items.

    11 Promote standardization of items used throughout Central Montana Medical Center.

    12 Negotiate, or help negotiate pricing, delivery, and discounts on products, utilizing contract
    pricing when available and appropriate.



    13 Responsible for coordination of contract services in each department.

    14 Acts as liaison for rental customers/ancillary departments

    15 Maintains system of records, while developing skills and knowledge in Materials Management
    system and use of Personal Computer.

    16 Maintains inventory of cleaning materials, supplies, and equipment and oversees their
    replacement for housekeeping and laundry

    17 Develop departmental budgets consistent with past experience and projected data.

    18 Monitor and control supply inventory levels, maintaining appropriate availability and investment
    costs.

    19 Inspects equipment used in performance of duties for proper functioning; makes minor repairs
    or adjustments.

    20 Responsible for counseling staff on protocol and departmental/facility policy.

    21 Instructs personnel in use of new equipment, cleaning techniques/methods, and cleaning
    agents.

    22 Inspects supplies and requisitions them from stock. Orders replacement supplies and linen for
    all departments.

    23 Demonstrates with the assistance of the Shift Leaders the use of cleaning materials and
    equipment and explains methods of cleaning to ensure the most efficient and economical use
    of materials and manpower

    24 Tours and inspects project areas for quality of work performed and adherence to established
    policies and procedures.

    25 Responsible for scheduling of purchasing staff. Review and approve schedules created by
    department leads in ES/Laundry

    26 Inspects housekeeping and hospital equipment for wear, tear, and replacement and prepares
    requisitions for maintenance or replacement.

    27 Performs other related duties as assigned or requested.

    Knowledge, Skills, Abilities:

    Communication skills to effectively relate to co-workers, physicians, vendors, patients, visitors, and
    the general public.
    Judgement to seek guidance and direction when needed, for performance of duties.
    Ability to adapt to fluctuations in work load, and prioritize work under these conditions.
    Willingness to assume additional work and duties when requested.

    OCCUPATIONAL EPOSURE for this position:

    Category I Direct contact with blood or other bodily fluid to which
    universal precautions apply

    Category II Activity performed without blood/bodily fluids exposure,
    but exposure may occur in emergency

    Category III Task/activity does not ordinarily entail predictable
    exposure to blood/bodily fluids

    OTHER EPOSURE for this position:

    Radiation

    Noise

    Other (Specify)

    PHYSICAL DEMANDS:
    (Essential functions strength rating for position - see Job Analysis)

    Sedentary Exert up to 10# occasionally or negligible force frequently

    Light Exert up to 20# occasionally, < 10# frequently or
    negligible force constantly


    Medium Exert up to 50# occasionally, up to 25# or up to 10#

    constantly

    Heavy Exert up to 100# occasionally, up to 50# frequently or up
    to 20# constantly

    Very Heavy Exert > 100# occasionally, > 50# frequently or
    > 20# constantly

  • 9 Days Ago

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Manager
  • Tamarack Brewing Company
  • Lakeside, MT FULL_TIME
  • Full job description The WOW Factor is What Sets Us Apart from the Others! We are seeking an experienced Restaurant Manager at our Lakeside Location. Our Restaurant Managers are responsible for all as...
  • 3 Days Ago

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Property Manager
  • Storage Rentals of America
  • Columbia, MT FULL_TIME
  • Storage Rentals of America is hiring a Property Manager to join our team. Become the newest member of our exciting team at SROA as we redefine self-storage!Are you the kind of person who gets bored wo...
  • 8 Days Ago

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Branch Manager
  • Speedy Glass US
  • Great Falls, MT FULL_TIME
  • Join the Speedy Glass Team and be part of something big! Speedy Glass has been an innovation leader in the auto glass repair and replacement industry for over 70 years operating 30 shops throughout th...
  • 8 Days Ago

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Parts Manager
  • Launch Watersports
  • Kalispell, MT FULL_TIME
  • Who We Are Launch Watersports is Montana’s largest, fastest growing marine dealership with two locations across the state. Our Kalispell dealership sits in the heart of the beautiful Flathead Valley, ...
  • 8 Days Ago

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Plant Manager
  • Contemporary Staffing Solutions
  • Shelby, MT FULL_TIME
  • Seeking a Plant Manager to join our client in Shelby, MT! The Plant Manager holds the critical responsibility of overseeing the entire production process within our client’s manufacturing facilities. ...
  • 8 Days Ago

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0 Appeal Resolution Manager jobs found in Great Falls, MT area

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Construction Project Manager
  • The Walsh Group
  • Great Falls, MT
  • Overview Walsh is currently seeking a Project Manager at Malmstrom AFB for our Federal Building Division in Great Falls,...
  • 4/17/2024 12:00:00 AM

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Fleet Shop Supervisor
  • Dairy Farmers of America
  • Great Falls, MT
  • General Purpose: Direct day-to-day operations of a DFA maintenance shop in the Mountain Area (MA) East or West, providin...
  • 4/17/2024 12:00:00 AM

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Psychiatric Nurse Practitioner (PNP)
  • Alluvion Health
  • Great Falls, MT
  • Job Description Job Description Position Title: Psychiatric Nurse Practitioner Department: Medical Supervisor: V.P. Medi...
  • 4/16/2024 12:00:00 AM

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Medical Doctor (MD) - Psychiatry
  • Alluvion Health
  • Great Falls, MT
  • Job Description Job Description Position Title: Psychiatrist Department: Medical Supervisor: V.P. Medical Operations Sup...
  • 4/16/2024 12:00:00 AM

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Medical Doctor (MD) - Family Practice Physician
  • Alluvion Health
  • Great Falls, MT
  • Job Description Job Description Position Title: Medical Doctor (MD) – Family Practice Physician Department: Medical Supe...
  • 4/16/2024 12:00:00 AM

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Order Picker
  • Walmart
  • Great Falls, MT
  • **Job Summary:** As an Order Picker at Walmart, you will be responsible for accurately and efficiently selecting merchan...
  • 4/15/2024 12:00:00 AM

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Picker / Packer
  • Walmart
  • Great Falls, MT
  • **Job Title: Picker/Packer** **Job Summary:** As a Picker/Packer at Walmart, you will play a critical role in the fulfil...
  • 4/14/2024 12:00:00 AM

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Shipping Associate
  • Walmart
  • Great Falls, MT
  • **Job Summary:** As a Shipping Associate at Walmart, you will be responsible for efficiently and accurately preparing me...
  • 4/14/2024 12:00:00 AM

Great Falls is a city in and the county seat of Cascade County, Montana, United States. The 2017 census estimate put the population at 58,638. The population was 58,505 at the 2010 census. It is the principal city of the Great Falls, Montana Metropolitan Statistical Area, which encompasses all of Cascade County and has a population of 82,278. Great Falls was the largest city in Montana from 1950 to 1970, when Billings surpassed it. Great Falls remained the second largest city in Montana until 2000, when it was passed by Missoula. Since then Great Falls has been the third largest city in the st...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Manager jobs
$83,171 to $108,091
Great Falls, Montana area prices
were up 3.1% from a year ago

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General provisions on appeals are contained within CPR PD 52A.
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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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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.
January 16, 2020