Appeals And Grievances Coordinator

About the role

The successful candidate will be responsible for overseeing grievance and appeal reviews, as well as conducting cultural and linguistic reviews for our subcontractors to ensure alignment with our commitment to diversity and inclusion. This role will provide support to the department on promoting health equity within our organization and in the community, ensuring fair and just access to healthcare services for all members.

Essential Duties And Responsibilities

• Conduct thorough reviews of grievances and appeals submitted by members to ensure compliance with regulatory requirements and company policies.
• Evaluate the cultural and linguistic competency of subcontractors and provide recommendations for improvement to enhance service delivery to diverse populations.
• Maintain department files for auditing purposes (hard and soft copies) per instruction.
• Develop and implement training programs to educate staff and subcontractors on cultural sensitivity and effective communication strategies.
• Collaborate with internal teams to address and resolve member complaints in a timely and efficient manner.
• Maintain department files for auditing purposes (hard and soft copies) per instruction.
• Provide support to champion health equity initiatives within the managed care system to address disparities in healthcare access and outcomes.

Experience Level

Intermediate Level

Job Type & Location

This is a Contract position based out of Fairfield, CA.

Pay And Benefits

The pay range for this position is $40.00 - $43.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision, Critical Illness, Accident, and Hospital, 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available, Life Insurance (Voluntary Life & AD&D for the employee and dependents), Short and long-term disability, Health Spending Account (HSA), Transportation benefits, Employee Assistance Program, Time Off/Leave (PTO, Vacation or Sick Leave).

Workplace Type

This is a fully onsite position in Fairfield,CA.

Application Deadline

This position is anticipated to close on Aug 7, 2026.