Grievances and Appeals Triage Specialist

This is a fully remote position, open to applicants in California.

📋 Description

• Implement, evaluate, and consistently enhance an ERP system.

• Concentrate on CTM and FCR tasks and monitoring.

• Analyze functional requirements and lead the intricate installation of ERP technologies to fulfill interdepartmental needs.

• Guarantee cross-functional access to systems.

• Employ ERP integration methodologies to align business processes with ERP modules, generally with support from consultants or vendors.

• Manage user acceptance testing.

• Liaise with programmers and specialists regarding file design, testing, debugging, storage, access, and associated activities.

• Create, deliver, and manage training and related materials for end users.

• Offer system support post-implementation as necessary.

• Uphold SCAN’s Vision and Goals.

• Execute additional tasks as assigned.

⛳️ Requirements

• 0-3 years of relevant experience (Grievance and Appeals, and ERP systems).

• Previous experience managing CTM and FCR tasks and monitoring within a Medicare Advantage Grievances and Appeals team is highly preferable.

• Associate's Degree, Technical Degree, or equivalent experience.

• Performs tasks under direct supervision.

• Addresses basic issues and problems, escalating more complex matters to higher-level staff.

• Possesses introductory to working knowledge of the subject matter.

• Basic technical skills in the functional area.

• Debugging abilities.

• Proficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams).

• Familiarity with Visio.

• Basic problem-solving capabilities.

• Strong communication and interpersonal skills.

• Background check is mandatory.

🏝️ Benefits

• An annual employee bonus program.

• Comprehensive Wellness Program.

• Generous paid time off (PTO).

• 11 paid holidays each year.

• 1 floating holiday.

• 1 birthday holiday.

• Exceptional 401(k) Retirement Savings Plan with employer matching and contributions.

• Comprehensive employee recognition program.

• Tuition reimbursement.

• Inclusive benefits.

• Equal pay programs.

• Employee resource groups.