Arizona Grievance & Appeals Lead

Arizona Complete Health; Arizona; In loco; USD 70.000 - 126.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

401K/Stock purchase plans

Tuition reimbursement

Paid time off

Flexible work arrangement

Descrizione del lavoro

Centene, a leading healthcare company, seeks an experienced Grievance & Appeals Coordinator to ensure timely processing of member grievances and appeals, and to serve as a primary contact with the State. The role manages day-to-day operations of the Grievance & Appeals Coordinators in Arizona.

The candidate will monitor trends, ensure compliance with contractual requirements, and work with state and local entities.

Competenze

• Bachelor’s degree in related field or equivalent experience.
• 3+ years of experience in healthcare/law, grievances and appeals.
• Lead in a functional area with cross-functional teams on large projects or supervisory experience including hiring, training, and evaluating staff.

Mansioni

• Ensure Grievance and Appeals processes align with defined time frames and contract requirements.
• Produce monthly reporting on trends for senior management.
• Process member and provider grievances per contract requirements.
• Collaborate with state, local, and federal entities on grievance/appeal matters.
• Incorporate federal and state law changes into governing regulatory systems.

Conoscenze

Grievances & Appeals

Healthcare industry knowledge

Regulatory compliance

Stakeholder communication

Formazione

Bachelor’s degree

Descrizione del lavoro

Centene, a leading healthcare company, seeks an experienced Grievance & Appeals Coordinator to ensure timely processing of member grievances and appeals, and to serve as a primary contact with the State. The role manages day-to-day operations of the Grievance & Appeals Coordinators in Arizona.

The candidate will monitor trends, ensure compliance with contractual requirements, and work with state and local entities.