Grievance Coordinator

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $44.1k - $54.8k / year

⏰ Full Time

🟢 Junior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Lumeris

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

Lumeris is a company focused on providing value-based care solutions within the healthcare industry. With over a decade of leadership in this field, Lumeris partners with health systems to improve patient outcomes and drive financial success through tech-enabled solutions. Their platform supports population health management, clinical delivery transformation, and payer contracting, offering comprehensive solutions for acute, post-acute, and high-risk patient management. Lumeris is recognized for creating significant cost savings and achieving excellent patient outcomes, including a 5-star CMS rating for its Medicare Advantage Prescription Drug Plan.

📋 Description

• Conduct thorough investigations into member complaints and identify all issues or components of each grievance • Achieve grievance resolution through action and education for members • Conduct root cause analysis on escalated member grievances to identify underlying system, plan, or provider issues • Research, gather information and evidence, and conduct timely outreach with members, providers, and internal and external partners • Review issues and assess appropriate resolution • Document investigations as accurate and complete chronological records of actions, communications, information obtained, member resolution, and notification • Ensure grievance resolutions reflect and fully address members' complaints • Manage several cases simultaneously in a high-volume, high-touch environment • Build rapport and collaborate across the organization • Recognize urgent and sensitive issues and escalate them promptly • Communicate assignment status in weekly internal meetings • Apply knowledge of complaints and plan processes to articulate issues and resolutions

🎯 Requirements

• Bachelors degree or equivalent • 1+ years of related work experience or the knowledge, skills, and abilities to succeed in the role • Authorized to work in the United States; visa sponsorship is unavailable • Ability to maintain high ethical standards • Good critical thinking and problem-solving skills • Ability to multi-task and operate effectively in both remote and in-person settings • Good investigatory skills with ability to organize, review, and effectively assess risk and appropriate response • Ability to remain fair and identify facts • Organizational skills for prioritizing tasks to meet set deadlines • Good communication and interpersonal skills with the ability to interact at all levels • Good customer service skills • Member-facing position • Initial series of an approved COVID-19 vaccine required for personnel interacting with at-risk members or prospects

🏖️ Benefits

• Medical, Vision and Dental Plans • Tax-Advantage Savings Accounts (FSA & HSA) • Life Insurance and Disability Insurance • Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days) • Employee Assistance Program • 401k with company match • Employee Resource Groups • Employee Discount Program • Learning and Development Opportunities • Performance-based incentive and/or equity may be available depending on the position • Approved COVID-19 vaccination coverage/requirement for member-facing personnel