Arizona Licensed Grievance Specialist

Job Summary

Responsible for reviewing, investigating, and tracking member grievances and appeals, the full-time Arizona Licensed Grievance Specialist will manage compliance with state regulations, coordinate appeal proceedings, and conduct investigations remotely.

Key responsibilities

• Screen incoming grievances, appeals, and provider claim disputes for compliance with Arizona laws and policies
• Conduct grievance investigations through interviews and documentation review, and write reports that meet regulatory standards
• Coordinate with relevant departments and assist in preparing for Fair Hearings and audits

Required qualifications

• Bachelor's degree or equivalent in a related field
• 2+ years of experience in behavioral health or physical health
• Experience processing grievances and appeals preferred
• Certification by Council on Licensure, Enforcement and Regulation (CLEAR) or equivalent, to be obtained within 6 months of hire
• 1-2 years of related experience required