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:

• Investigate and resolve moderately complex grievances and appeals cases, collaborating with cross-functional partners
• Document case management activities and ensure compliance with internal and external regulations
• Provide customer service by communicating case statuses and outcomes to members and stakeholders

Required qualifications:

• Bachelor's degree in Business Administration, Health Care Administration, or related field, or equivalent experience
• Minimum one year of experience in customer service or a related field
• Two years of experience in health care, health insurance, or a directly related field, or five years of relevant experience without a degree
• Knowledge of health care compliance and incident management processes
• Ability to manage complex cases and maintain confidentiality of sensitive information