California Licensed Incident Management Specialist

Job Summary

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