Senior Coordinator, Complaint & Appeals - Remote

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality 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. Position Summary: Provide support to the Supervisors by coaching, mentoring and training new staff. Oversight over inventory. -Serves as a content model expert and mentor to team regarding Aetna's policies and procedures, regulatory and accreditation requirements. -Ensures work of team meets federal and state requirements and quality measures, with respect to letter content and turn-around time for appeals, complaints and grievances handling. -Independently researches and translates policy and procedures into intelligent and logically written responses for Executive or Senior leaders on escalated cases. -Successfully works across functions, segments, and teams to create, populate, and trend reports to find resolution to escalated cases. -Identify...