Incident Management Specialist III
Job Summary
Working remotely in a full-time capacity, the Incident Management Specialist III will coordinate and monitor the resolution of grievances and appeals cases, investigate issues, and collaborate with cross-functional teams to ensure compliance and satisfactory resolutions for members.
Key responsibilities:
- Manage and resolve moderately complex grievances and appeals by investigating cases and communicating with members and stakeholders
- Monitor case tracking databases to identify and analyze trends in incident cases requiring resolution
- Document case activities while maintaining confidentiality and ensuring compliance with internal and external regulations
Required qualifications:
- Bachelor's degree in Business Administration, Health Care Administration, or a related field, or equivalent experience
- Minimum of two (2) years of experience in health care, health insurance, or a directly related field
- At least one (1) year of experience in customer service or a related area
- Knowledge of health care compliance and incident management processes
- Experience in negotiation and stakeholder management
Complete Job Description
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