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Case Review Grievance Analyst

Company: VirtualVocations
Location: Plano
Posted on: September 21, 2023

Job Description:

A company is looking for a Case Review Grievance Analyst.
Key Responsibilities:

Review and ensure Grievance resolutions align with CMS guidelines and address member concerns
Provide feedback to caseworkers on the quality of written grievances resolution letters and summaries
Conduct root-cause analysis and make process improvement recommendations to enhance the member experience

Required Qualifications:

2+ years of experience with Microsoft Office Suite
1+ years of Med D work experience
2+ years of general business experience
1+ year of PBM/pharmaceutical related work strongly desired
High school diploma or equivalent; Bachelor's degree preferred

Keywords: VirtualVocations, Plano , Case Review Grievance Analyst, Professions , Plano, Texas

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