Grievance Resolution Specialist

at CalOptima
Location Orange, CA
Date Posted June 2, 2020
Category Operations
Job Type Full-time

Description

State and Federal regulations regarding the healthcare industry. Develops resolution letters and correspondence to members and providers. Coordinates and/or participate in case discussion with operational experts to result in a final case disposition as needed. Ensures data collection, summarization, integration, and reporting which includes case creation and management and events/activity...