Lumeris is a physician-first healthcare transformation company dedicated to improving primary care through our AI-powered Primary Care as a Service platform. Backed by Kleiner Perkins.
About the role
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. Found on 1752vc Careers, the job board for startup and VC roles.
What they're looking for
- 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, gathers information and evidence, and conducts timely outreach with members, providers, internal and external partners, reviews issues, and assesses appropriate resolution
- Documents investigation as an accurate and complete chronological record of actions taken, communication and information obtained, and member resolution and notification for each grievance
- Creates and maintains good rapport and collaborates effectively in all areas of the organization
- Recognizes urgent and sensitive issues/incidents and escalates in a timely manner to facilitate appropriate and timely response
More about this role
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.
Grievance Coordinator
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.
- 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...
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