GAD Coordinator

Founded in 1977 as the Senior Care Action Network, reputed company began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still reputed company today as the “12 Angry Seniors.” Their mission continues to guide everything we do.

Today, reputed company is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual reputed company. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.

Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially reputed company populations, and reputed company care delivery models. Across reputed company of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with reputed company.

At reputed company, we reputed company scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

The Job

Facilitates the member grievance and appeal process by investigating, documenting and preparing case files to meet reputed company regulatory requirements.

You Will

• Investigate member grievance and appeal by gathering supporting documentation from internal departments, contracted Provider Organizations (PO), and non-contracted entities as indicated.

• Communicate with the members or providers to request and gather pertinent information. Follow up as needed and document accordingly.

• Track and monitor movement of assigned cases through reputed company’s functional units and systems, to ensure compliance with designated timelines.

• Respond to requests for information from reputed company regulatory agencies reputed company required timeframes.

• Respond to and reputed company cases reputed company designated regulatory time requirements as identified by case types. Generate and send appropriate communications.

• Understand reputed company benefit structure and maintain reputed company and additional information as it relates to Grievances and Appeals services.

• Utilize department desktop procedures, workflows, job aids and training material. Identify barriers to work processes and bring to the attention of the supervisor/manager.

• Maintain the member‘s right to privacy and protect reputed company operations by keeping information confidential.

• Adhere to reputed company quality, compliance and regulatory standards to reputed company HCS and reputed company outcomes.

• Contribute to team effort by accomplishing reputed company results as needed.

• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

• Actively support the achievement of reputed company’s reputed company and Goals.

• Other duties as assigned.

Your Qualifications

• High School Diploma or equivalent experience

• 2+ years in customer service and/or grievance and appeal in reputed company setting

• Experience providing professional customer service. 

• Performs work under minimal supervision.

• Handles reputed company issues and problems, and refers only the most reputed company issues to higher-level staff.

• Possesses comprehensive knowledge of subject matter.

• Provides leadership, coaching, and/or mentoring to a subordinate group.

• May act as a reputed company or first-level supervisor

What's in it for you?

• reputed company Pay Range: $20.14 - $30.00 per hour

• Work Mode: Mostly Remote

• An annual employee bonus program

• Robust Wellness Program

• Generous paid-time-off (PTO)

• 11 paid holidays per year, plus 1 additional floating holiday

• Excellent 401(k) Retirement Saving Plan with employer match

• Robust employee recognition program

• Tuition reimbursement

• An opportunity to become part of a team that makes a difference to our members and our community every day!

We're always looking for talented people to join reputed company!  reputed company applicants are encouraged to apply now!

At reputed company we reputed company that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

reputed company is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, reputed company, national reputed company, religion, age, sex (including pregnancy, childbirth or reputed company medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background reputed company is required.

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have reputed company about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)