Mar 07, 2026
Kaiser Permanente
Job Summary: In addition to the responsibilities listed below, this position also coordinates and monitors the resolution of grievances and appeals cases by investigating, communicating with members and their advocates both verbally and in writing, preparing presentations of all relevant documentation to medical committees for medical service determinations and reconsiderations; identifying and partnering with appropriate entities to process escalations with an elevated level of complexity and a heightened level of resolution; reviewing cases and confirming documentationis prepared for decision making processes; leveraging a comprehensive foundational knowledgeof the product/service domain to contribute to satisfactory resolutions of moderately complex customer and member grievances and appeals with appropriate groups and departments (e.g., Medical Group, Health Plan); resolving issues for members related to health care delivery, benefits, or financial...
Professional Diversity Network
Portland, OR, USA
Full-Time
