Medicare Grievances & Appeals Lead (Partially Remote)

SCAN Health Plan; Long Beach (CA); Hybride; USD 28 000 - 40 000; Plein temps

Avantages offerts par ce poste

Annual Bonus program

Wellness Program

Generous PTO

11 paid holidays + floating holiday +

Birthday holiday

401(k) with employer match

Tuition reimbursement

Employee recognition program

Résumé du poste

SCAN Health Plan is seeking a GAD Coordinator to lead a team of Member Services Representatives focused on Medicare Part C and D grievances. You will ensure inquiries are addressed, verify member identity, and refer members to appropriate service providers.

This role supports member retention, maintains accurate databases, and contributes to program enhancements based on feedback. Partial remote work, a mission-driven culture, and growth within a national nonprofit health plan are offered.

Qualifications

• 0–3 years of related experience in Grievances and Appeals for a health plan, healthcare, or managed care organization.
• Knowledge of Medicare Part C and D grievances and closing out grievances is highly desirable.
• High school diploma or equivalent required.
• Strong customer service and communication skills.

Responsabilités

• Coordinate the work of a team of Member Services Representatives.
• Ensure member inquiries are addressed and referred to appropriate service providers.
• Verify member identity, membership status, and entitlement to services.
• Maintain current and accurate membership databases and records.
• Suggest new service offerings or revisions based on member feedback or gaps in coverage.
• Support member retention or renewal efforts as needed.

Connaissances

Customer service

MS Office (Advanced)

Problem solving

Communication

Leadership

Medicare knowledge

Team supervision

Formation

High school diploma

Outils

IKA

MHK

QNXT

Description du poste

SCAN Health Plan is seeking a GAD Coordinator to lead a team of Member Services Representatives focused on Medicare Part C and D grievances. You will ensure inquiries are addressed, verify member identity, and refer members to appropriate service providers.

This role supports member retention, maintains accurate databases, and contributes to program enhancements based on feedback. Partial remote work, a mission-driven culture, and growth within a national nonprofit health plan are offered.