Incident Management Specialist III

Job Summary

Resolving moderately complex grievances and appeals, the full-time Incident Management Specialist III will coordinate case investigations, communicate with members and their advocates, and ensure compliance with regulations while working remotely.

Key responsibilities:

• Manage and monitor the resolution of grievances and appeals cases, collaborating with cross-functional teams
• Conduct research and analysis on incident cases, ensuring compliance with internal and external regulations
• Provide customer service by communicating case statuses and resolving issues for members and stakeholders

Required qualifications:

• Minimum one (1) year of experience in customer service or a directly related field
• Bachelor's degree in Business Administration, Health Care Administration, or related field AND two (2) years of relevant experience, or five (5) years of experience in health care or related fields
• Knowledge of health care compliance and incident management processes
• Ability to manage complex relationships and resolve conflicts effectively
• Proficiency in Microsoft Office and data entry skills