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Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd Street-Full-Time-Days -Remote

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Mount Sinai Health System
πŸ“ New York, United States
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Location New York
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Posted April 07, 2026
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Commute Local Area
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Job Description


Description

Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd Street-Full-Time-Days -Remote

The Director, Pre Appeals Management is a strategic enterprise leader who provides strategic leadership and operational oversight for the hospital’s pre-appeals management program. This role ensures the appropriate use of medical resources, compliance with regulatory standards, and coordination of care to improve patient outcomes while controlling costs. The Director collaborates closely with medical staff, vendors, case management, and payers to secure payment and benefits for beneficiaries that is in alignment with the clinical care provided.


Responsibilities
  • Lead and manage the pre appeals department and related vendors , including supervision of pre appeals nurses, and support staff.
  • Develop and implement pre appeals strategies, policies, and procedures to ensure regulatory compliance (CMS, The Joint Commission, NCQA, ...
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    πŸ“ Location Details

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    City
    New York
    πŸ—ΊοΈ
    Country
    United States
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    Commute
    Local Area

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