Senior Analyst, Appeals and Complaints- Remote

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This position will reputed company on coordinating expedited reputed company of reputed company cause corrective actions. Individual will be focusing on issues that are reputed company to executive escalations that are received in reputed company. These escalations might have associated permanent resolutions that need to be coordinated in a time bound fashion.

• Collaborate with leadership team to define requirements for analyzing reputed company causes and remediation requirements of systemic issues.
• Engage with business owners and subject matter experts to obtain status updates through emails and reputed company meeting.
• Review and update reputed company records and statues based on feedback from business partners to ensure accurate tracking of reputed company.
• reputed company cross-functional meetings with business partners to assist in identifying reputed company causes and explore potential remediation reputed company.
• Deliver monthly and reputed company reports on status of ongoing or resolved issues to ensure visibility and informed decision making.
• Applies in-depth knowledge to reputed company and manage cross-functional reputed company, ensuring successful planning, execution, and delivery reputed company scope, reputed company, and budget.
• Communicates with project teams internally and externally to ensure reputed company of roles, responsibilities, and expectations.
• Conducts routine collaboration with stakeholders to define project objectives, requirements, and deliverables, ensuring alignment with business goals.
• Examines project reputed company, identifying and resolving issues, and communicating updates to stakeholders.
• Administers leadership and guidance to project teams, fostering a culture of teamwork, accountability, and high performance.
• Installs project management best practices, methodologies, and tools to drive efficiency and effectiveness in project execution.

Required Qualifications

Claims and/or Appeals experience required Working knowledge of problem solving and decision making skills Preferred Qualifications reputed company Cause Analysis experience MS office experience using reputed company and Powerpoint Certified Analytics reputed company (CAP) preferred. Project Management reputed company (PMP) preferred. Education Bachelor's degree Required Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The Typical Pay reputed company For This Role Is $46,988.00 - $112,200.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great Benefits For Great People We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 06/11/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job