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Grievance and Appeals Quality Analyst
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Job Description
- Req#: 1080
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $42.80 per hour
- Excellent benefits package, including medical, dental, and vision coverage with HPSM-paid premiums
- Fully paid life, AD&D, and LTD insurance
- Generous retirement plan with employer contributions equivalent to 10% of annual compensation
- 12 paid holidays, 12 paid sick days, and vacation starting at 16 days per year
- Opportunity for ongoing training and development in a supportive environment
What to Expect (Job Responsibilities):
- Analyze data and processes to identify trends related to operational or quality issues within the Grievance and Appeals department
- Design and produce data visualizations, including tables, graphs, and charts, to support reporting and analysis
- Develop and implement work plans and training sessions for department staff, addressing team needs and regulatory requirements
- Maintain department procedures, workflows, and training materials while identifying barriers to work processes
- Lead team preparation for audits and collaborate with internal teams to ensure accurate G&A reporting
What is Required (Qualifications):
- Bachelor's Degree preferred
- Minimum of 3 years of experience in managed care and/or grievance and appeal in a healthcare environment
- Knowledge of quantitative and qualitative analysis, database management, and healthcare compliance systems
- Strong written and verbal communication skills with attention to detail
- Ability to prioritize tasks and work effectively in a fast-paced environment
How to Stand Out (Preferred Qualifications):
- Experience with Medicare/Medicaid processes
- Expertise in training and facilitation skills in both group and one-on-one settings
- Familiarity with local, state, and federal health plan regulations
- Strong critical thinking and analytical skills
- Proven ability to build collaborative relationships within cross-functional teams
#HealthcareServices #GrievanceAndAppeals #DataAnalysis #CareerOpportunity #EmployeeBenefits
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