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 and monitor 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 case management activities and maintain confidentiality while ensuring compliance with internal and external regulations
• Provide customer service by communicating case statuses and outcomes to members and stakeholders in a timely manner

Required qualifications:

• Bachelor's degree in Business Administration, Health Care Administration, or related field, or equivalent experience in health care or health insurance
• Minimum of two (2) years of experience in health care, health insurance, sales, or marketing, or five (5) years of related experience
• Experience in incident management and health care compliance
• Proficiency in Microsoft Office and data entry
• Ability to manage diverse relationships and demonstrate adaptability in a fast-paced environment