Job Information
Magellan Health Services Grievance Coordinator in San Diego, California
Coordinates grievance process as assigned, attends to risk management issues associated with case management and processes grievance requests.
Performs outreach contact and written notification with members with resolution to Grievances.
Consults with internal departments, to ensure Grievances resolutions meet all guidelines and result in customer satisfaction.
Responsible for preparation of written detailed case history.
Documents process and findings within the Grievance and internal systems.
Interfaces with members and providers as required regarding status, process and outcomes of complaints.
Maintains the integrity of the company relationship with customers by researching, resolving and responding to customer inquiries for disputes.
Identifies risk situations and escalates to supervisor as appropriate.
Researches, compiles and consults with external review organization and customers as necessary.
Achieves and maintains department performance goals.
Assists in developing workflows and innovative process improvements to positively impact the department overall.
Meets individual performance standards.
Other duties as assigned.
Other Job Requirements
Responsibilities
Experience in customer interactions and detailed review of health-related materials.
Strong interpersonal skills and attention to detail.
Ability to organize work and seek help on tasks where needed.
Ability and willingness to learn new software applications.
Professional writing and proofing skills required ensuring documents meet standards and are accurate.
General Job Information
Title
Grievance Coordinator
Grade
19
Work Experience - Required
Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Associate
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$37,725
Salary Maximum:
$56,595
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.
Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .
Warning: Employment Scam
It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. “Interviews” are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.
Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.
If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911