Manager, Appeals and Grievances
HealthfirstNew York, New York, United States • Florida, United States
Posted March 10, 2026
103400 - 149430 USD
Full Time
About the Company
Healthfirst believes that every New Yorker deserves access to the best available healthcare. As one of New York’s highest quality not-for-profit health insurers serving close to two million New Yorkers, we make this a reality for our members. Founded more than 30 years ago by the leading hospital systems in downstate New York, Healthfirst established a partnership model that enables hospitals, health systems, and physicians in our network to prioritize health outcomes over profits, placing the needs of our members and community first. Healthfirst serves members in New York City, on Long Island, and in Westchester, Rockland, Sullivan, and Orange counties, offering market-leading products to suit every life stage. Our offerings include Medicaid plans, Medicare Advantage plans, Child Health Plus plans, Essential Plans, Long-Term Care plans, and Qualified Health plans. For more information on Healthfirst, please visit healthfirst.org.
Job Description
The Manager, Appeals & Grievances is responsible for leading, operating, and advising a dynamic and fast-paced Appeals & Grievances team.
Requirements
- Bachelor's degree from an accredited institution or equivalent work experience
- Experience with appeals and grievance processing and compliance
- Experience building and managing a team and leading work processes in a fast-paced environment
- Experience preparing and delivering written and verbal information to multiple types of audiences
- Demonstrated ability to work well with others, understand process flows and correlating platforms, recommend options and implement solutions
- Experience setting direction for department and managing staff performance
- Experience managing multiple concurrent priorities
- Proven ability to work across areas in an organization to yield results
Benefits
- Medical, dental and vision coverage
- Incentive and recognition programs
- Life insurance
- 401k contributions
