Incident Management Specialist III

Job Summary

Working remotely on a full-time basis, the Incident Management Specialist III will manage the resolution of grievances and appeals cases by investigating issues, collaborating with members and stakeholders, and ensuring compliance with regulations.

Key responsibilities:

• Coordinate and monitor the resolution of grievances and appeals, preparing documentation for medical committees
• Perform incident case management by analyzing case data and resolving moderately complex cases
• Provide customer service by communicating case statuses and addressing concerns from members and stakeholders

Required qualifications:

• Bachelor's degree in Business Administration, Health Care Administration, or a related field, or five years of relevant experience
• Minimum one year of experience in customer service or a directly related field
• 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