Alliance Health
Grievance & Appeals Analyst (Full time Remote, North Carolina Based)
This job is now closed
Job Description
- Req#: GRIEV002514
Employer Industry: Healthcare Services
Why Consider this Job Opportunity:
- Salary up to $39.06/hourly
- Opportunity for career advancement and growth within the organization
- Full-time remote work opportunity
- Comprehensive fringe benefit package, including medical, dental, vision, life, and long-term disability insurance
- Flexible work schedules, including hybrid/remote options
- Generous retirement savings plan
- Paid time off, including vacation, sick leave, holiday, and management leave
- Dress flexibility
What to Expect (Job Responsibilities):
- Respond to grievances and appeals, ensuring compliance with organizational policies and state/federal guidelines
- Analyze and synthesize data from various sources to identify trends and emerging issues
- Mediate complex relationships between external and internal stakeholders to reach satisfactory resolutions
- Manage timelines and review quality assurance reports in a timely manner
- Prepare and maintain appeal files, participate in the development of internal training, and assist with legal processes
What is Required (Qualifications):
- Bachelor's degree in a related field
- Minimum of 2 years of experience in human services/behavioral health or data analysis
- Knowledge of federal and state regulations on behavioral healthcare grievances and appeals processes
- Proficiency in MS Excel and other software packages
- Strong oral, written, and presentation skills
How to Stand Out (Preferred Qualifications):
- Experience in customer service or provider relations
- Experience working with individuals with mental health, substance abuse issues, and/or intellectual disabilities
#HealthcareServices #CareerOpportunity #RemoteWork #CompetitivePay #FlexibleSchedule
We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
We are the managed care organization for public behavioral healthcare for the citizens of Cumberland, Durham, Johnston, Mecklenburg, Orange, and Wake counties.
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.