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Manager, Clinician Appeals, Active RN License Required
CorroHealthManager of Clinician Appeals responsible for oversight of appeal letter writing and clinical engagement. Leading teams with a focus on operational excellence and compliance within revenue cycle.
About the role
Key responsibilities & impact- The Manager of Clinician Appeals is responsible for the strategic oversight and operational execution of the appeals letter writing and client education engagement.
- Lead high-performing clinical teams in the development of clinically accurate, persuasive, and compliant appeal communications to payers.
- Ensure operational excellence, clinical integrity, and alignment with financial goals.
- Work closely with internal leadership, administrative operations, and external clients to ensure best-in-class service delivery.
- Build, lead, and scale the clinical letter writing team, ensuring appropriate staffing levels aligned to current and forecasted client demand.
- Oversee hiring, onboarding, training, and performance management of clinical writers.
- Define and implement the team’s leadership structure and workflows. Enforce quality and productivity standards.
- Develop and continuously improve robust QA programs ensuring appeal content meets or exceeds clinical accuracy, appropriateness, and grammatical standards.
- Understand the appeals financial model and associated KPIs; align clinical operations to meet or exceed revenue and margin targets.
- Identify and champion process improvement and efficiency initiatives to increase clinical team productivity without compromising quality.
Requirements
What you’ll need- RN, MD or DO license required; active, unrestricted medical license (any state) preferred.
- Minimum 8+ years of clinical experience with at least 5 years in a leadership role within appeals, utilization management, clinical documentation improvement (CDI), or similar RCM functions.
- DRG Downgrade experience is mandatory.
- Strong knowledge of payer appeals processes, healthcare regulations, and documentation standards.
- Demonstrated success in managing clinical teams in a high-volume, fast-paced environment.
- Proven experience developing QA programs and implementing clinical workflow improvements.
- Strong understanding of financial models and operational KPIs in the revenue cycle industry.
- Exceptional communication, collaboration, and leadership skills.
Benefits
Comp & perks- Competitive annual salary
- Medical/Dental/Vision Insurance
- Equipment provided
- 401k matching program
- FTO: Flex Unlimited Annual PTO
- Paid Paternity & Maternity leave programs
- 9 paid annual holidays
- Life Insurance
- Long term disability
- Short term disability options
- Tuition reimbursement and much more!
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical documentation improvementappeals letter writingquality assurance programsclinical workflow improvementsfinancial modelsoperational KPIsDRG downgrade
Soft Skills
leadershipcommunicationcollaborationteam managementprocess improvement
Certifications
RN licenseMD licenseDO license