Grievances & Appeals Professional
Remote Wisconsinremote
Posted today · via Workday
About this role
Become a part of our caring community Join Humana's Wisconsin Medicaid team as a Grievances and Appeals Professional and make a meaningful impact in the lives of our members. Reporting to the Manager of Consumer Engagement, you will advocate for member rights and ensure fair treatment by reviewing clinical documentation thoroughly and resolving concerns with skill and integrity. You will collaborate with dedicated clinical experts and teams across Humana to deliver thoughtful final determinations on grievances and appeals. Main Responsibilities: Review, research, and help resolve formal grievances, appeals, informal complaints, and member concerns following applicable requirements and deadlines.…
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
For this role: monday, teams, hipaa
2
Level fit
We check your title trajectory against the seniority signal of the role.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is remote-eligible — we factor in your stated location and time-zone overlap.
Score yourself on this role.
Free · no card · written explanation included
Skills in this role
Pulled from the job description. These are the keywords we'll weight when scoring your fit.
mondayteamshipaa
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