Director, Appeals & Grievances - Remote Strategy Lead

Sentara Health Plans in Virginia Beach region seeks a Director of Appeals and Grievance to plan, develop, and direct the department across Commercial, Medicaid, and Medicare lines of business. This role leads program development, strategic planning, and operational execution for Appeals and Grievances.

You will establish policies and workflows, oversee complaints and appeals reporting, collaborate with Medical Directors to adjust criteria, and ensure regulatory compliance, external audits, and