Illinois Licensed Grievance Coordinator

Job Summary

Supporting the Illinois Health Plan Medicaid and YouthCare grievance and appeals processing team, the full-time remote Lead Grievance & Appeals Coordinator will manage a smaller caseload, provide updates on daily case completion, and oversee team performance while ensuring compliance with internal standards.

Key responsibilities

• Monitor team workload and output to ensure compliance with internal and NCQA standards
• Provide training and support for new and existing team members on processes and policies
• Prepare for audits and respond to complaints, ensuring appropriate documentation and reporting

Required qualifications

• Bachelor's degree in a related field or equivalent experience
• 2+ years of grievance and appeals experience in a Healthcare or Managed Care setting
• Experience with state fair hearing processes and compliance standards