Medicare Grievance Investigator – Remote

Devoted Health; United States; Remote; USD 32,000 - 36,000; Full time

Benefits offered by this job

Health, dental & vision plan

Generous paid time off

$100 monthly mobile/internet stipend

Stock options

Bonus eligibility

Parental leave

401(k) program

Job summary

Devoted Health in the United States seeks a Grievance Specialist to resolve member grievances with accuracy and compassion, ensuring regulatory compliance and timely resolutions. You will collaborate across teams and document thoroughly.

The role emphasizes attention to detail, empathy for members, and opportunities to improve processes and member experience while supporting Devoted Health's mission to care for every person like family.

Qualifications

• Experience with Medicare Advantage appeals and grievances.
• Strong attention to detail and commitment to data accuracy.
• Adaptability to changing regulations, priorities, or case volumes.
• Excellent customer service and conflict resolution skills when interacting with members.
• Strong time management and organizational skills with deadlines.
• Ability to work independently and as part of a collaborative team.
• Strong written and verbal communication skills; ability to explain complex information clearly.

Responsibilities

• Maintain up-to-date knowledge of Devoted Health products, benefits, policies, and procedures.
• Support a culture of continuous learning and member advocacy.
• Conduct thorough investigations by reviewing case details, member records, and policies for root cause analysis.
• Triage work to ensure grievances are categorized and routed correctly.
• Communicate with members through written correspondence and telephone while upholding regulatory requirements.
• Complete accurate documentation and data entry across multiple systems.
• Ensure grievances are resolved within required regulatory timelines.
• Collaborate with internal partners to gather information and resolve cases thoroughly.
• Identify themes and opportunities for process or member experience improvements.

Skills

Medicare grievances experience

Attention to detail

Adaptability

Customer service

Time management

Independent & collaborative

Communication skills

Education

Bachelor’s degree or equivalent in healthcare/medicare

Job description

Devoted Health in the United States seeks a Grievance Specialist to resolve member grievances with accuracy and compassion, ensuring regulatory compliance and timely resolutions. You will collaborate across teams and document thoroughly.

The role emphasizes attention to detail, empathy for members, and opportunities to improve processes and member experience while supporting Devoted Health's mission to care for every person like family.