Member Grievance and Appeals Manager, Healthy Blue Kansas Sign On Bonus Eligible

Location:
  • KS-TOPEKA, 1133 SW TOPEKA BLVD, United States of America
  • Kansas +50 Miles away from nearest Pulse Point
  • Kansas - Overland Park
  • Kansas - Topeka
  • Kansas - Wichita
Job Reference:
JR127431
Date Posted:
10/09/2024
Anticipated Date Close:
10/14/2024

Member Grievance and Appeals Manager, Healthy Blue Kansas

Sign On Bonus Eligible


Location: Topeka KS, Wichita, KS or Overland Park, KS

This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Kansas Elevance Health PulsePoint locations.

The Member Grievance and Appeals- Business Change Advisor is responsible for representing the Member Grievance and Appeals department in all business requirements for executing the KS contract in bridging the gap between internal and external stakeholders to achieve expected business performance levels and desired results.

How you will make an impact: 
•    Provides subject matter expertise in response to day-to-day external client-facing business issues. 
•    Communicates externally to multiple stakeholders on contract requirements 
•    Manages external client-facing relationships and partners with corporate and regional business areas.

Minimum Requirements:

  • BA/BS and a minimum of 2 years of related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • Experience with Member Grievances, Appeals, administrative hearings, or other legal processes
  • Presentation Skills with the ability to create and present information
  • External client-facing experience
  • Knowledge of Medicaid Managed Care Programs
  • Ability to interpret contract language
  • Previous experience as a legal assistant or paralegal is preferred

 

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. 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.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.