Grievance Coordinator

Your Future is our Future At Lumeris , we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. We're excited to consider every qualified candidate authorized to work in the United States, although we are unable to sponsor visas for this role at this time. Position: Grievance Coordinator Position Summary: Works an important part of the Medicare Grievances Program, which is the heartbeat of Plan operations and a direct insight to member experience. Reviews and investigates member complaints and works with internal and external partners to reach mitigation and resolution for the member. Handles each grievance in accordance with organizational and regulatory guidelines. Job Description: Primary Responsibilities Conducts thorough investigations into member complaints, identifies all issues or components of the grievance, and achieves resolution through action and education to the member. Utilizes senior resources as needed. Conducts rigorous root cause analysis on escalated member grievances, using structured diagnostic techniques to identify underlying system, plan, or provider issues. Researches,