Incident Management Specialist III

Job Summary

To support grievance and appeals management, the full-time Incident Management Specialist III will coordinate and monitor case resolutions, investigate issues, and collaborate with cross-functional teams to address member challenges in a remote work environment.

Key responsibilities:

• Manage the resolution of grievances and appeals by investigating cases and preparing documentation for medical committees
• Collaborate with cross-functional partners to resolve member-related issues, ensuring compliance with regulations
• Document case activities and maintain confidentiality while providing accurate information to 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 a related field, or equivalent experience
• Minimum two (2) years of experience in health care, health insurance, or a related field
• Knowledge of health care compliance and incident management processes
• Strong interpersonal skills and ability to manage diverse relationships