-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:45
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Portland, US-OR
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:45
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Oklahoma City, US-OK
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:44
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Tulsa, US-OK
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:43
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Cincinnati, US-OH
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:42
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Eugene, US-OR
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:42
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Wilmington, US-NC
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:41
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Minot, US-ND
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:40
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Columbus, US-OH
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:39
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Fargo, US-ND
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:39
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Cleveland, US-OH
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:38
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Las Cruces, US-NM
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:36
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Albany, US-NY
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:33
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Charlotte, US-NC
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:30
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Buffalo, US-NY
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:27
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Rochester, US-NY
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:24
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Cherry Hill, US-NJ
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:21
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Lebanon, US-NH
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:18
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Reno, US-NV
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:14
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Newark, US-NJ
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:14
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Albuquerque, US-NM
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:13
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Manchester, US-NH
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:12
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Omaha, US-NE
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:12
-
Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Missoula, US-MT
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:11
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Essential Duties and Responsibilities:
- Manage assigned teams and staff.
- Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).
- Perform other duties as assigned by management.
- Oversees the day-to-day operations of the Appeals department.
- Ensures appeals are reviewed and resolved in a timely manner.
- Maintains accuracy and consistency in appeal determinations.
- Ensures compliance with regulatory, contractual, and company requirements.
- Monitors team performance, productivity, and workload distribution.
- Performs Monthly Quality Checks.
- Provides monthly and as-needed coaching, guidance, and performance feedback to team members.
- Oversees compliance with policies, procedures, and regulatory guidelines.
- Identifies and implements process improvement opportunities.
- Drives operational efficiency and workflow optimization.
- Analyzes trends and performance metrics to improve outcomes.
- Collaborates with management to address escalated issues.
- Supports a positive customer experience through fair and effective appeal resolution.
- Promotes continuous improvement initiatives to enhance service quality and customer satisfaction.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Familiarity with Appeals & Hearings is required.
Expertise within the Hearings & Appeals function is strongly preferred.
- Current and/or prior managerial experience.
- Ability to work a schedule between the hours of 9:00am - 6:00pm EST Monday - Friday.
- Flexibility to work extended hours and rotational weekends.
Preferred Skills and Qualifications:
- Knowledge of and experience with healthcare appeals.
- Quality check, review, and/or assessment experience.
- Experience working with Salesforce.
- Familiarity with the Affordable Care Act.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
E...
....Read more...
Type: Permanent Location: Las Vegas, US-NV
Salary / Rate: Not Specified
Posted: 2026-08-12 09:54:10
