Senior Lead Analyst
4 weeks ago
Job Summary:
The Grievance and Appeals Lead will be responsible for leading and coaching a team of analysts in the Enterprise Grievance and Appeals Department. This role will involve reviewing, analyzing, and processing grievances and appeals requests related to clinical and non-clinical services, quality of service, and quality of care issues.
Key Responsibilities:
- Lead and coach a team of analysts to ensure the correct utilization of guidelines and review tools to conduct extensive research and analyze grievances and appeal issues.
- Monitor workflow and make assignments to ensure accreditation and regulatory compliance metrics are met in a quality manner.
- Provide review and analysis of complex grievances and appeals requests from customers and multiple products related to clinical and non-clinical services, quality of service, and quality of care issues.
- Coaches, trains, and audits team members to ensure they correctly utilize guidelines and review tools.
Requirements:
- Minimum of 3 years of Grievance and Appeals Senior Analyst experience.
- Strong leadership and coaching skills.
- Ability to analyze complex data and make informed decisions.
- Excellent communication and interpersonal skills.
About Elevance Health:
Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
What We Offer:
- Market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs.
- Medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.
- A culture that is designed to advance our strategy and lead to personal and professional growth for our associates.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.
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