California Licensed Incident Management Specialist

Job Summary

To support the resolution of grievances and appeals, 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 monitor the resolution of moderately complex grievances and appeals cases, collaborating with cross-functional teams
• Conduct research and documentation for incident cases, ensuring compliance with internal and external regulations
• Provide customer service by communicating case statuses and resolving issues for members and stakeholders

Required qualifications

• Minimum one (1) year of experience in customer service or a directly related field
• Bachelor's degree in Business Administration, Health Care Administration, or a related field, along with two (2) years of relevant experience, or five (5) years of experience in health care or health insurance
• Knowledge of health care compliance and incident management processes
• Experience in handling moderately complex grievances and appeals
• Proficiency in Microsoft Office and data entry tasks