Oregon Licensed Incident Management Specialist

Job Summary

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

Key responsibilities

• Manage the resolution of moderately complex grievances and appeals by investigating cases and preparing documentation for medical committees
• Collaborate with cross-functional teams to address member challenges related to health care delivery and benefits
• Monitor and analyze case tracking databases to identify and resolve specialty or flagged incident cases

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, plus two (2) years of relevant experience, or five (5) years of experience in health care or insurance
• 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