Incident Management Specialist III

Job Summary

To support the resolution of grievances and appeals, the full-time Incident Management Specialist III will manage case investigations, communicate with members and advocates, and ensure compliance with regulations while working remotely.

Key responsibilities:

• Coordinate and monitor the resolution of grievances and appeals cases, preparing documentation for medical committees
• Analyze case tracking databases to identify and resolve moderately complex incident cases
• Provide accurate information and support to members and stakeholders regarding case statuses and outcomes

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 experience in health care or related field, OR five (5) years of experience in health care or related field
• Knowledge of health care compliance and incident management processes
• Experience with case documentation and maintaining confidentiality of sensitive information
• Ability to work autonomously and collaborate cross-functionally to resolve issues