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Welcome to CommonSpirit Careers

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Supervisor Appeals and Grievances

  • Dignity Health Management Services
  • Bakersfield, California, Remote
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About Us

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 138 hospital-based locations, in addition to its home-based services and virtual care offerings.

Our Mission

As CommonSpirit Health, we make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all. To learn more about a calling that defines and unites, please click here for more information about our mission, vision, and values.

The posted compensation range of $36.00 - $51.08 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Job ID
2026-464127
Employment Type
Full Time
Department
Compliance
Hours/Pay Period
80
Weekly Schedule
Monday-Friday 8am-5pm
Shift
Day
Remote
Yes
Category
Risk and Compliance

Job Summary and Responsibilities

The Appeals and Grievances Supervisor is responsible for managing and coordinating the appeals and grievance process within Dignity Health MSO. The Supervisor will lead a team of coordinators providing guidance, training, and support to ensure the highest standards of patient service and regulatory compliance.
This role involves handling member and provider complaints, ensuring compliance with regulatory requirements, and facilitating timely and effective resolution of appeals and grievances. Acting a subject matter expert (SME), the Supervisor will work closely with internal teams and external stakeholders to ensure a high level of service and satisfaction.
The Supervisor oversees a mix of operational, business and regulatory activities related to several Health Plan Partnerships. This position will work closely with health plan partners to ensure a seamless transition in implementing new and ongoing regulatory requirements. From a business perspective, this role is responsible for the ongoing delegation and performance of our contractual obligations.


- Supervise a team of appeals and grievances coordinators. Develop and implement strategies to improve team performance and efficiency.
- Receive, document, and manage member and provider appeals and grievances in accordance with Dignity Health MSOs organizational policies and regulatory standards. Ensure all cases are processed within required timeframes and follow-up actions are completed properly. Prepare and present reports on appeals and grievances activity to senior management.
- Maintain detailed and accurate records of all appeals and grievances, including documentation of investigations, outcome, and communications.
- Manages and works closely with Regulatory partners in the management of identified patient populations. Oversees a mix of operational, clinical, educational and business activities as they relate to this partnership.
- Conducts relevant research into complaints and collaborates, coordinates and communicates with various departments (i.e. Member Services, Care Management, Claims), as well as external entities (i.e. Providers and Vendors) to collect additional information as necessary.
- Monitor and analyze trends in appeals and grievances to identify systemic issues and recommend corrective actions. Prepare and submit regular reporting on appeals and grievance activity, trends, and outcomes to management and regulatory agencies as required.

***This position is remote within California.


Job Requirements

Minimum Qualifications:


- 3+ years of experience in healthcare appeals and grievances, with at least 2 years in a supervisory or leadership role.
- Associates degree or 3 years of related job or industry experience in lieu of degree.
- Familiarity with healthcare regulations, including HIPAA, CMS, and state-specific requirements.

Preferred Qualifications:

- Previous appeals and grievances experience at a health plan, managed care organization and IPA strongly preferred.

- Previous experience in claims, UM or provider relations a plus.
- Bachelors degree in a relevant field (e.g., healthcare management, business administration, compliance) or 5 years of related job or industry experience in lieu of degree preferred.
- Knowledge of DMHC, NCQA, CMS and other regulatory bodies preferred.
- Strong technical proficiency in data analysis; database software preferred.
- Regulatory audit experience preferred.
- Certified Compliance Professional, Certified Professional in Healthcare Quality, or Certified Healthcare Auditor preferred.

#LI-DH

Where You'll Work

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.


Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

One Community. One Mission. One California 

Total Rewards

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.

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CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.

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