Job description

Our Grievance Analyst are empowered to provide each Customer with the best experience possible through the clear and timely resolution of the concerns and feedback members share. Grievance Analysts will champion customer resolutions in this WORK FROM HOME opportunity.

A keen eye for details, passion for serving the unique needs of the Medicare population, and superior critical-thinking and communication skills will be the keys to success for the successful candidates in this mission-critical role. Earning a position in this high-achieving group puts you on a team that has visibility straight to the Executive Leadership level and the potential to help directly increase our rising Net Promoter Score.

ESSENTIAL DUTIES AND RESPONSIBILITIES

As our customers share concerns and provide us with valuable feedback, your ability to recognize and complete the steps necessary to meet their needs will leave a permanent, lasting impression of the passion you have for helping them be at their best.

We make sure our customers are not alone when it comes to understanding their benefits and they will rely on you to advocate for them as you would your own family member.

In addition to the keys to success identified above that you will bring with you to the team, you will need to demonstrate the following abilities:

· Strong verbal communication skills

· Exceptional written communication skills

· Strong problem-solving abilities

· Strong investigational skills

· Comfortable working in environment where performance is based on Net Promoter/C-Sat scores

· Basic comfort level with technology

· Aptitude for learning new software

· Ability to translate and articulate complicated and multi-layered information into simple messages

· Analytic mind that enjoys putting together clues found throughout a variety of information sources

· Orchestration of cross-departmental and inter-organizational investigation

· Unwavering dedication to serving a customer that has complex needs

· Adherence to following internal policy

· Natural contributor to environment that rewards identification of potential process improvements

• Interest in earning workgroup leadership opportunities for Customer Experience improvement initiatives
• Ability to switch gears and enjoy making contributions across a variety of initiatives with little advance notice
• Interest in continuously expanding the scope of your expertise through experience and training activities
• Must be able to work with minimal supervision and be a valued team member.
• Highly regulated industry, with accountability for meeting Centers for Medicare and Medicaid requirements.

EDUCATION AND EXPERIENCE:

· Preferred minimum of two-year degree, or higher, in Pharmacy, Business, and/or Hospitality preferred

· Preferred two or more years of experience working with Grievance and Appeals, claims, or customer service in call center environment

· Desired one or more years of experience working with Pharmacy Benefit Manager (PBM), Experience in Health Plan, managed care plan or Part D/Prescription Drug plan sponsor

· Someone that shares our passion for providing our customers with the best experience possible will be considered

· Comfortable working in fast paced environment with the ability to work with tight deadlines

· Comfortable performing with monotonous tasks at times

Job Type: Full-time

Pay: $18.00 - $20.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Overtime

Work Location: One location

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