Appeals & Grievances / Customer Service Senior Manager

Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale.
We are a talent and innovation led company with 738,000 people serving clients in more than 120 countries.
Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships.
We combine our strength in technology with unmatched industry experience, functional expertise and global delivery capability.
We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Accenture Song.
These capabilities, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients succeed and build trusted, lasting relationships.
We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities.
As the Senior Manager of Appeals Grievances/Customer Service, they will lead and manage the Customer Services Operation and the department that oversees Appeals and Grievances.
Key Responsibilities include: Oversee the efficient and high quality Customer Care Operations that is able to answer customer inquiries in a timely nature and at a high customer satisfaction rate in line with regulations, guidelines and policies.
Monitor and evaluate Customer Service Operations key metrics and take actions to drive performance in line with guidelines.
Monitor and evaluate incoming Appeals and Grievances to understand reasons and trend.
Ensure processing of these Appeals and Grievances is performed in line with regulations, guidelines and policies.
Collaborate with external stakeholders, including regulatory bodies and insurers, to ensure compliance and effective processing of appeals and grievances.
Basic Qualifications Minimum of 7 years of experience in healthcare customer care management Minimum of 3 years in a managerial or leadership role Preferred Qualifications Bachelors degree in Healthcare Administration, Business, or a related field Masters degree preferred .
In depth knowledge of customer service operations in healthcare regulations, policies, and procedures.
Strong leadership skills with the ability to manage and inspire a team.
Excellent analytical, problem solving, and decision making abilities.
Effective communication and interpersonal skills.
Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience.
As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, New York or Washington as set forth below.
Information on benefits is here.
Role Location Annual Salary Range California $131,100 to $271,000 Colorado $131,100 to $234,100 New York $121,400 to $271,000 Washington $139,600 to $249,300 What We Believe We have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization.
As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment.
Inclusion and diversity are fundamental to our culture and core values.
Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities.
Read more here Equal Employment Opportunity Statement Accenture is an Equal Opportunity Employer.
We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion or sexual orientation.
All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.
Accenture is committed to providing veteran employment opportunities to our service men and women.
For details, view a copy of the Accenture Equal Employment Opportunity and Affirmative Action Policy Statement.
Requesting An Accommodation Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed.
If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process.
Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired.
If you would like to be considered for employment opportunities with Accenture and have accommodation needs for a disability or religious observance, please call us toll free at 1 (877) 889-9009, send us an email or speak with your recruiter.
Other Employment Statements Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States.
Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.
Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process.
The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.