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Experienced Operations Coordinator
2 months ago
Your Role
The Commercial Appeals and Grievances team is dedicated to conducting thorough investigations concerning member complaints, appeals, and grievances. The Experienced Operations Specialist in this area will report directly to a Supervisor within the Commercial Appeals and Grievances team. In this capacity, you will collaborate with the leadership team to ensure that all Desk Level Procedures (DLPs) are current and precise. Your responsibilities will include assisting the leadership team with compliance, quality assurance, productivity, workflow management, process enhancements, employee engagement, and fostering relationships with a diverse array of cross-functional business partners.
Your Responsibilities
In this position, you will:
- Serve as a subject matter expert, reviewing operational processes, identifying issues, conducting root cause analyses, and proposing improvements and modifications.
- Manage databases essential for business operations.
- Create and assess tools and resources that boost operational efficiency, accuracy, and the technical skill levels of team members.
- Generate and present reports for management evaluation; alert relevant department managers about operational workflow issues that require immediate resolution.
- Act as a subject matter expert in formulating written guidelines and documenting issues as necessary.
- Assist the leadership team during current and future system modifications and upgrades.
- Facilitate and promote employee engagement initiatives.
- Perform additional tasks as required.
Your Expertise and Background
- A bachelor's degree or equivalent experience is required.
- A minimum of 3 years of relevant experience is necessary.
- At least 1 year of experience in Appeals & Grievances is essential.
- Proficiency in the job area typically acquired through experience is required.
- Exceptional attention to detail, analytical abilities, communication, and problem-solving skills are crucial.
- Ability to work independently and consistently meet deadlines is necessary.
- Note: Placement may occur in a specialized client or other unit.
The compensation range for this position is: $66,800 to $93,400 for California.
About the Team
Blue Shield of California is committed to ensuring that all Californians have access to high-quality healthcare at a sustainably affordable price. We are transforming healthcare to genuinely fulfill our nonprofit mission by reducing costs, enhancing quality, and improving the member and physician experience. To achieve our mission, we prioritize creating a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meeting the needs of the diverse communities we serve. Our ongoing commitment to diversity, equity, and inclusion supports our values and advances our goal of establishing a healthcare system that is worthy of our families and friends while addressing health disparities, promoting social justice, and integrating health equity into our products and business practices.