California Licensed Incident Management Specialist

Job Summary

Working remotely in a full-time capacity, the California Licensed Incident Management Specialist will coordinate and monitor the resolution of grievances and appeals cases, investigate issues, communicate with members, and prepare documentation for medical committees.

Key responsibilities:

• Manage the resolution process for moderately complex grievances and appeals, ensuring compliance with regulations
• Conduct research and analysis of incident cases, collaborating with cross-functional teams to resolve issues
• Document case activities and maintain confidentiality while providing customer service to members and stakeholders

Required qualifications:

• Bachelor's degree in Business Administration, Health Care Administration, or related field, or equivalent experience
• Minimum of two years of experience in health care, health insurance, or a related field
• At least one year of experience in customer service or a directly related field
• Knowledge of health care compliance and incident management processes
• Proficiency in Microsoft Office and data entry skills