About this role

To support grievance and appeals resolution, the full-time California Licensed Incident Management Specialist will coordinate case investigations, communicate with members and advocates, and ensure compliance with regulations while working remotely. Key responsibilities: Manage and resolve moderately complex grievances and appeals by investigating cases and collaborating with cross-functional teams Document and maintain confidentiality of case information while ensuring compliance with internal and external regulations Provide customer service by communicating case status and outcomes to members and stakeholders, addressing concerns effectively Required qualifications: Bachelor's degree in Business Administration, Health Care Administration, or a related field, or equivalent experience Minimum of two (2) years of experience in health care, health insurance, or a directly related field At least one (1) year of experience in customer service or a related area Knowledge of health care compliance and incident management processes Strong interpersonal skills and ability to manage diverse relationships

Source listing: virtualvocations_main