Grievance Champion - Healthcare
On-siteDavao, Davao Region, Philippines
Davao, Davao Region, PhilippinesOn-siteFull TimeSenior LevelLarge
Full TimeSenior LevelLarge
Job Summary
Serve as a subject matter expert and senior-level support resource for U.S. healthcare contact center operations by providing floor support, coaching, grievance resolution assistance, process guidance, and escalation management. Act as a liaison between frontline agents, leadership, quality, training, and operations teams to drive performance improvement, enhance customer experience, and support successful resolution of complex member and provider inquiries while ensuring compliance with client, regulatory, and operational requirements.
Required Qualifications
- strong healthcare knowledge
- leadership capabilities
- coaching skills
- experience supporting Medicare, Medicaid, Marketplace, Commercial Health Plans, Managed Care, Provider Services, or Grievance and Appeals programs
Desired Qualifications
- Associate's degree in Healthcare Administration, Business, Communications, Nursing, or a related field; equivalent experience may be considered
- 3+ years of healthcare customer service or healthcare BPO experience
- Experience supporting Medicare Annual Enrollment Period (AEP) and Open Enrollment programs
- Experience in Grievance & Appeals, Quality Assurance, Training, or Workforce Support functions
- Experience working with healthcare case management systems and reporting tools
- Leadership, Coaching, or Healthcare Compliance certifications preferred
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