Attorney Manager, Appeals & Rebuttals
1 day ago
Jacksonville
Attorney Manager, Appeals & Rebuttals A healthcare services organization is seeking an attorney-trained leader to manage provider and supplier enrollment appeals and rebuttals in a CMS-regulated Medicare environment. This is a law-degree-required management role responsible for overseeing appeal and rebuttal operations, guiding attorney-level written work, evaluating complex case records, and ensuring outcomes are timely, well-documented, and aligned with CMS guidance, contractual requirements, and internal procedures. Candidates must have a J.D. and/or LL.M. from an ABA-accredited law school plus post-law-degree experience in administrative law or legal writing and research. Candidates without these qualifications will not be considered. This role is a remote, permanent opportunity with occasional travel as needed for client-related meetings. Applicants without the required law degree and post-law-degree legal experience will not be considered. Compensation: • Base salary: $100,000 to $130,000, • Bonus: 10% target bonus Work Model: • Remote, • Approved hiring states only: AL, FL, GA, MS, NC, SC, TX, or PA, • Preference for candidates near Northeast Florida or Mechanicsburg, PA, but this is not required, • Travel may be required based on client needs, though frequency is not yet defined Position Overview: The Attorney Manager, Appeals & Rebuttals, leads the day-to-day management of provider and supplier enrollment appeal and rebuttal operations in a structured Medicare environment. This role requires strong legal writing and research capability, sound regulatory judgment, disciplined execution, and the ability to manage complex administrative case workflows with consistency and precision. This individual will supervise approximately 4 to 6 direct reports, maintain performance metrics for timeliness and quality, and partner closely with leadership, compliance, and legal stakeholders to support accurate, evidence-based case outcomes. This is not a general healthcare operation, grievance-only, provider enrollment-only, paralegal, claims, revenue cycle, or compliance-only management role. It is a law-degree-required legal operations role for candidates with attorney-level writing, research, and administrative review experience. Key Responsibilities: Legal Operations, Leadership, and Compliance: • Lead daily operations for provider and supplier enrollment appeals and rebuttals in a CMS-regulated environment, • Supervise and develop a small team responsible for appeal and rebuttal workflow, written case development, quality review, and administrative case processing, • Maintain team performance metrics tied to timeliness, quality, and compliance expectations, • Review complex appeal and rebuttal matters, assess facts and documentation, and guide consistent, well-supported outcomes aligned with CMS guidance and contractual requirements, • Ensure appeal and rebuttal narratives are supported by evidence, policy, and regulatory requirements, • Translate contractual and regulatory updates into operational workflows, written procedures, and team guidance, • Identify trends, risks, and process improvement opportunities and escalate issues as appropriate, • Support development and maintenance of documentation standards, administrative record quality, and defensible case handling practices Appeals and Rebuttal Strategy: • Lead strategy for appeal and rebuttal responses involving provider and supplier enrollment determinations, • Oversee the preparation and review of written narratives, case summaries, and supporting documentation, • Establish and maintain processes that promote timely, accurate, and compliant case handling, • Use workflow and performance data to identify recurring issues, improve quality, and strengthen operational consistency, • Incorporate findings into training, process updates, and policy refinement Cross-Functional Collaboration: • Serve as a subject matter resource and escalation point for internal leaders and partner teams, • Coordinate with internal and external legal stakeholders on documentation, case strategy, and administrative record development, • Support interactions with federal client stakeholders as needed regarding appealable and rebuttable determinations, • Collaborate across teams to improve upstream processes and reduce avoidable appeal volume, • Present trends, risks, and recommendations to senior leadership Required Qualifications: • J.D. and/or LL.M. from an ABA-accredited law school, • 3+ years of experience in administrative law or post-J.D./post-LL.M. legal writing and research, • 5+ years of supervisory or team leadership experience in legal writing, legal research, and/or administrative law, • Demonstrated ability to make objective decisions in a structured, high-compliance environment, • Experience analyzing workflows and performance data to improve operations and support regulatory compliance, • Strong verbal and written communication skills, • Ability to collaborate effectively across leadership, compliance, legal, and partner teams, • Ability to pass an additional Government ICT background investigation required for access to government systems Preferred Qualifications: • Supervisory or management experience in a Medicare production environment, • Experience supporting provider or supplier enrollment appeals, rebuttals, or related regulatory operations, • Experience working with CMS guidance, federal program requirements, and contractual service obligations, • Experience managing teams responsible for structured case review, written determinations, or administrative review workflows Ideal Background: • Prior experience leading structured appeals or rebuttal workflows in a highly regulated environment, • Strong legal writing and documentation discipline, • Experience reviewing complex records, applying policy and regulatory requirements, and guiding consistent outcomes, • Experience operating in environments where timeliness, quality, compliance, and audit readiness are critical, • Comfort working in a highly structured role with repetitive review responsibilities and clear performance expectations Additional Information: • Approximately 4 to 6 direct reports, • Role supports a function required by a federal client, • Travel may be needed for client-related meetings, • Start timing is flexible for the right candidate Application: Candidates with an ABA-accredited J.D. and/or LL.M., attorney-level legal writing and research experience, and management experience in administrative law or regulated healthcare appeals environments are encouraged to apply. Applicants without the required law degree and post-law-degree legal experience will not be considered.