Incident Management Specialist III

Job Summary

To support the resolution of grievances and appeals, the full-time Incident Management Specialist III will coordinate investigations, communicate with members and advocates, and prepare documentation for medical committees while working remotely.

Key responsibilities:

• Coordinate and monitor the resolution of grievances and appeals cases, ensuring compliance with regulations
• Perform incident case management by analyzing case data and resolving moderately complex cases
• Provide customer service by communicating case statuses and addressing concerns of members and stakeholders

Required qualifications:

• Bachelor's degree in Business Administration, Health Care Administration, or related field, or equivalent experience
• Minimum of two years of experience in health care, health insurance, or a related field
• At least one year of experience in customer service or a directly related field
• Knowledge of health care compliance and incident management processes
• Strong interpersonal skills and ability to manage diverse relationships