Case Manager – Appeals & Grievances (California)

Immediate need for a talented professional. This is a 06 months contract opportunity with long-term potential and is located in California (Remote).

Job Details

• Job ID: 26-16668
• Pay Range: $20 - $30/hour
• Benefits: Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities

• Investigate, coordinate, and resolve member complaints, grievances, and appeals in compliance with health plan and regulatory standards.
• Ensure timely and fair resolutions, accurate documentation, and strong cross-functional collaboration.

Key Requirements and Technology Experience

• 3 years experience in Appeals, Grievances, Utilization Management, or Care Coordination in a health plan or TPA.
• Strong understanding of CMS, DMHC, and NCQA regulatory standards.

About the Client

Our client is a leading Healthcare Industry organization, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Equal Opportunity Employer

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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