Case Review Grievance Analyst

Job Summary

A company is looking for a Case Review Grievance Analyst.

Key Responsibilities:

• Review and ensure Grievance resolutions align with CMS guidelines and address member concerns
• Provide feedback to caseworkers on the quality of written grievances resolution letters and summaries
• Conduct root-cause analysis and make process improvement recommendations to enhance the member experience

Required Qualifications:

• 2+ years of experience with Microsoft Office Suite
• 1+ years of Med D work experience
• 2+ years of general business experience
• 1+ year of PBM/pharmaceutical related work strongly desired
• High school diploma or equivalent; Bachelor's degree preferred