Strengthen Your Appeals & Grievances Program in a High-Stakes Environment
The RISE Virtual Event Series: Appeals & Grievances is built for teams in the thick of it - managing rising volumes, tighter timelines, and growing scrutiny, all while trying to deliver a better member experience.
Right now, plans are facing a perfect storm: increased audit activity, more complex cases, and mounting pressure to resolve issues quickly and accurately. The result? Backlogs, inconsistent processes, and higher risk.
This event is designed to help you regain control.
You’ll walk away with practical ways to:
- Keep pace with rising case volumes without sacrificing accuracy or turnaround times
- Reduce operational friction across appeals, grievances, and utilization management teams
- Strengthen documentation and decision-making consistency in a more scrutinized environment
- Improve how you communicate with members to reduce confusion, repeat grievances, and complaints
We’ll also dig into how leading plans are using their appeals and grievances data more strategically, turning everyday operations into insights that drive better performance across the organization.
The Topics Shaping Tomorrow & How to Stay Ahead
Explore Regulatory Updates and Audit Preparedness
Gain clarity on CMS and state requirements and strengthen documentation, workflows, and controls to stay audit-ready.
Learn How to Strengthen Appeals, Grievances, and Utilization Management Coordination
Improve cross-team collaboration to reduce appeal volumes, strengthen medical necessity decisions, and ensure consistent case handling.
Discover Ways to Improve Member Communication and Accessibility
Create clearer, compliant communications that improve member understanding, reduce repeat grievances, and meet ADA requirements.
Thinking About Attending? Here's Why You Should
- Stay ahead of CMS and state scrutiny with the latest compliance insights and audit readiness strategies
- Strengthen documentation, workflows, and controls to confidently withstand audits
- Reduce appeal volumes and improve decision-making through better utilization management and appeals & grievances coordination
- Elevate member communications to reduce confusion, repeat grievances, and ensure ADA compliance
- Leverage data, technology, and oversight strategies to build a more efficient, future-ready appeals and grievances program
You'll Be in Good Company
Discover the types of peers you'll be joining virtually.
Organizations That Attend
- Health Plans: Medicare Advantage, Multi-Line, Commercial, & Medicaid
- Accountable Care Organizations
- Community-Based Organizations, Government Agencies, & Advocacy Groups
- Physician Practices, Medical Groups, & Hospitals
- IPA Management or MSO Companies
- Integrated Delivery Networks
- Not-For-Profit Organizations & Health Care Foundations
- Pharmacy Benefit Managers
- Pharmaceutical Manufacturers
- Prescription Drug Plans
- Consultants & Vendors That Provide Platforms and Solutions
- Auditors
- Academia & Employer Groups
Job Functions You'll Network With
- Appeals & Grievances Operations
- Utilization Management
- Compliance
- Call Center Operations
- Internal & External Audit
- Member Experience
- Clinical Services & Operations
- Customer Service and Member Services
- FDR Oversight
- Quality Improvement/STARS
Stay in the Know!
Sign up below to receive event updates directly to your inbox.