Remote Appeals & Grievances Analytics Analyst

Harbor Health; Texas; Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Fully remote work environment

Competitive salary and benefits

Generous PTO

10 paid holidays

Medical, Dental, and Vision Insurance

401(k) Investment Plan

Professional development

Job summary

Harbor Health is seeking a data-minded Appeals & Grievances Analyst to monitor, analyze, and optimize health plan complaints, grievances, and appeals in a remote Texas role supporting IFP/Marketplace and large group products.

You will track regulatory Turnaround Times, identify bottlenecks, perform root-cause trend analyses, prepare audit universes, and ensure reporting integrity across administrative platforms.

Qualifications

• Bachelor's degree or equivalent in a healthcare/analytic field.
• 3–5 years of managed care or health plan analytics experience.
• 2+ years focused on Appeals & Grievances, compliance reporting, or healthcare complaint analytics.

Responsibilities

• Monitor regulatory reporting and audit universe management across DOIs and NCQA.
• Perform root-cause trend analyses on member/provider complaints to identify drivers.
• Translate analytical findings into corrective action plans with Operations and Quality.
• Design dashboards and data visualizations to support leadership reporting.

Skills

Data analysis

Regulatory reporting

Dashboarding

Root-cause analysis

Excel/Sheets

Education

Bachelor's degree in Healthcare Analytics/Health Information Management/Business/Statistics/Public Health

Tools

AxisCore platform

SQL

Claims processing systems

Job description

Harbor Health is seeking a data-minded Appeals & Grievances Analyst to monitor, analyze, and optimize health plan complaints, grievances, and appeals in a remote Texas role supporting IFP/Marketplace and large group products.

You will track regulatory Turnaround Times, identify bottlenecks, perform root-cause trend analyses, prepare audit universes, and ensure reporting integrity across administrative platforms.