Grievances and Appeals (GAD) Triage Specialist

SCAN Health Plan • Long Beach, CA

9d • Remote

About The Position

The GAD Triage Specialist is responsible for implementing, analyzing, and continuously improving an ERP system. This role will focus on CTM and FCR work and tracking. We seek Rebels who are curious about AI and its power to transform how we operate and serve our members. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned.

Requirements

• 0-3 years of related (Grievance and Appeals, and ERP systems) experience.
• Associate's Degree or Technical Degree or equivalent experience.
• Performs work under direct supervision.
• Handles basic issues and problems, and refers more complex issues to higher-level staff.
• Possesses beginning to working knowledge of subject matter.
• Technical expertise - Basic technical skills for functional area
• Debugging skills.
• Required PC Skills - MS Office (Word, Excel, PowerPoint, Outlook, Teams), Visio Design expertise.
• Problem Solving - Basic problem solving skills
• Communication - Good communication and interpersonal skills

Nice To Haves

• Prior experience in handling CTM and FCR work and tracking on a Medicare Advantage Grievances and Appeals team is highly desirable.

Responsibilities

• Assess functional requirements and initiates complex installations of ERP technologies that meet interdepartmental needs.
• Ensures cross-functional access to systems; utilizes ERP integration methodologies to map business processes to ERP modules (typically with assistance from consultants or vendors) and administers user acceptance testing.
• Has knowledge of ERP languages and communicates with programmers and other specialists on matters of file design, testing, debugging, storage, access, and related activities.
• Documents, delivers, and administers training and related materials to end users.
• May provide system support following implementation.

Benefits

• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• 11 paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree