Remote Appeals & Grievances Data Analyst

Harbor Health; Austin (TX); Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Fully remote work environment

Competitive salary and benefits

Generous PTO

10 paid holidays

Medical, Dental, Vision Insurance

401(k) Investment Plan

Professional development opportunities

Collaborative culture

Job summary

Harbor Health is seeking an Appeals & Grievances Analyst to monitor, analyze, and optimize our health plan complaints, grievances, and appeals operations. This remote role supports our Texas fully insured IFP/Marketplace and large group products.

You will partner with Operations, Quality, Utilization Management, and Network Management to translate analytical findings into corrective actions and leadership dashboards.

Qualifications

• Bachelor’s degree in a healthcare analytics or related field.
• 3–5 years of managed care or health plan experience with 2+ years in A&G or analytics.
• Understanding of Commercial health insurance structures and ACA/Marketplace plans.
• Knowledge of A&G reporting requirements and TAT standards.

Responsibilities

• Monitor regulatory reporting and audit universe management for compliance.
• Analyze trends in member/provider grievances to identify root causes.
• Maintain data quality in grievance systems and support dashboard reporting.
• Collaborate with Operations, Quality, Utilization Management, and Network Management to drive improvements.

Education

Bachelor’s degree in Healthcare Analytics, Health Information Management, Business, Statistics, Public Health, or a related field

Tools

AxisCore platform

Excel/Sheets

Relational databases

Job description

Harbor Health is seeking an Appeals & Grievances Analyst to monitor, analyze, and optimize our health plan complaints, grievances, and appeals operations. This remote role supports our Texas fully insured IFP/Marketplace and large group products.

You will partner with Operations, Quality, Utilization Management, and Network Management to translate analytical findings into corrective actions and leadership dashboards.