Grievance Coordinator - San Diego, United States - Magellan Health

Magellan Health

Verified Company

San Diego, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Coordinates grievance process as assigned, attends to risk management issues associated with case management and processes grievance requests.

Performs outreach contact and written notification with members with resolution to Grievances.
Consults with internal departments, to ensure Grievances resolutions meet all guidelines and result in customer satisfaction.
Responsible for preparation of written detailed case history.
Documents process and findings within the Grievance and internal systems.
Interfaces with members and providers as required regarding status, process and outcomes of complaints.
Maintains the integrity of the company relationship with customers by researching, resolving and responding to customer inquiries for disputes.
Identifies risk situations and escalates to supervisor as appropriate.
Researches, compiles and consults with external review organization and customers as necessary.
Achieves and maintains department performance goals.
Assists in developing workflows and innovative process improvements to positively impact the department overall.
Meets individual performance standards.
Other duties as assigned.

Other Job Requirements

Responsibilities
Experience in customer interactions and detailed review of health-related materials.

Strong interpersonal skills and attention to detail.

Ability to organize work and seek help on tasks where needed.

Professional writing and proofing skills required ensuring documents meet standards and are accurate.

General Job Information

Title
Grievance Coordinator

Grade
19

Work Experience - Required
Customer Service

Work Experience - Preferred

Education - Required
GED, High School

Education - Preferred
Associate

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:
$37,725

Salary Maximum:
$56,59- This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law._

This position may be eligible for shortterm incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing._

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.