Incident Management Specialist III

Job Summary

Focused on resolving grievances and appeals, the full-time Incident Management Specialist III will investigate cases, 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 and processing moderately complex cases and reporting trends
• 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 related field
• Bachelor's degree in Business Administration, Health Care Administration, or a related field AND two (2) years of relevant experience, or five (5) years of experience in a related field
• Knowledge of health care compliance and incident management processes
• Strong interpersonal skills and ability to manage diverse relationships
• Proficiency in Microsoft Office and data entry