UPMC Health Plan is hiring a full-time Member C&G Coordinator I in the Member C&G department. This position works Monday through Friday, daylight hours and will be a remote position.

The Member C&G Coordinator, I will track, trend, and manage member complaints and grievances for all product lines. Ensure the efficient and effective resolution of member complaints and grievances. Use the data collection and analysis to target initiatives for opportunities for improvement within the Health Plan.

Responsibilities:

+ Investigate member complaints and grievances, and provider appeals, and respond in writing according to department standards.
+ Effectively utilize key internal and external Health Plan contacts, including Health Plan staff, providers, and external review organizations, to help in this process.
+ Organize all tasks within regulatory requirements/deadlines.
+ Ensure member and provider concerns are thoroughly and accurately addressed accordi...