Quality Analyst, Grievance and Appeals
Job Description:
• Applies in-depth knowledge of subject matter and independently coaches others on matters regarding complaints and appeals
• Ensures compliance with federal and/or state regulations
• Prepares and participates in external and internal audits
• Analyzes quality and completeness of documentation
• Contributes to process improvements by recommending changes
• Assists in analyzing patterns, trends, and systemic issues
• Compiles reports on quality metrics
• Facilitates inquiries and maintaining a customer-centric approach
• Acts as a liaison between the organization and relevant individuals
Requirements:
• 1+ years of Compliance experience
• 1+ years of External Audit Experience
• 1+ years of Grievance and Appeals Experience
• 1+ Medicare and/or Medicaid experience
• High School Diploma or GED
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings
• Tobacco cessation and weight management programs
• Confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
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