MedImpact Healthcare Systems, Inc.
Appeals & Grievances Implementation Specialist
MedImpact Healthcare Systems, Inc., San Diego, California, United States, 92189
Appeals & Grievances Implementation Specialist
role at
MedImpact Healthcare Systems, Inc.
Job Overview The Appeals & Grievances Implementation Specialist reports to the Appeals & Grievances Manager and collaborates with the Prior Authorization Implementation team. This role is responsible for the implementation and maintenance of client‑facing appeals and grievances processes, including system configuration, testing, vendor oversight, and performance tracking.
Responsibilities
Coordinates client implementations and system conversions by collaborating with IT services,, implementation, prior authorization, accreditation, legal, and client teams.
Attends MedImpact implementation meetings such as status, operations, IQ review, compliance, and PA implementation meetings to gather business requirements and share client delegation information.
Serves as a subject matter expert on implementation activities and processes related to MedImpact’s Appeals and Grievances products and services, and as a Medical Affairs resource for related inquiries.
Acts as the principal or supporting liaison between MedImpact Medical Affairs, Appeals and Grievances, and the client team during the implementation or conversion process.
Conducts internal processing platform configuration tasks for implementation and maintenance of business for Appeal and Grievance clients, including timers, letters, reason codes, HiTrust audits, and system access.
Demonstrates system tools to internal and external groups when necessary.
Monitors and tracks vendor activities related to productivity, quality, and reporting.
Maintains confidentiality of all member, provider, client, and proprietary information.
Monitors and reports all information related to Performance Guarantees.
Performs transactions in relevant MedImpact systems with competency.
Stays knowledgeable regarding company policies, procedures, and current departmental developments.
Qualifications
B.S./B.A. and 3+ years’ experience or equivalent combination of education and experience.
Advanced knowledge of MS Office, including Word, Excel, PowerPoint, Visio, and Outlook. Experience using multiple business software applications is required.
Advanced working knowledge of key business applications such as MedOptimize, MedAccess, and other applicable tools preferred.
Current and unrestricted State Pharmacy Technician License required; National Pharmacy Technician certification preferred.
Strong interpersonal skills with the ability to establish and maintain effective business relationships with clients and internal staff.
Experience with business process management and business rules management applications is strongly preferred.
Benefits
Medical / Dental / Vision / Wellness Programs
Paid Time Off / Company Paid Holidays
Incentive Compensation
401(k) with Company match
Life and Disability Insurance
Tuition Reimbursement
Employee Referral Bonus
Work Location & Schedule This full‑time, non‑exempt position is based at the San Diego Headquarters. The role requires occasional travel to local conferences and meetings. Regular office hours are Monday through Friday, 8:00 a.m. to 5:00 p.m., with the flexibility to work nights, weekends, or holidays as needed to meet business requirements.
Equal Opportunity Employer, Male/Female/Disabilities/Veterans
To explore all that MedImpact has to offer, please submit your resume to www.medimpact.com/careers
#J-18808-Ljbffr
role at
MedImpact Healthcare Systems, Inc.
Job Overview The Appeals & Grievances Implementation Specialist reports to the Appeals & Grievances Manager and collaborates with the Prior Authorization Implementation team. This role is responsible for the implementation and maintenance of client‑facing appeals and grievances processes, including system configuration, testing, vendor oversight, and performance tracking.
Responsibilities
Coordinates client implementations and system conversions by collaborating with IT services,, implementation, prior authorization, accreditation, legal, and client teams.
Attends MedImpact implementation meetings such as status, operations, IQ review, compliance, and PA implementation meetings to gather business requirements and share client delegation information.
Serves as a subject matter expert on implementation activities and processes related to MedImpact’s Appeals and Grievances products and services, and as a Medical Affairs resource for related inquiries.
Acts as the principal or supporting liaison between MedImpact Medical Affairs, Appeals and Grievances, and the client team during the implementation or conversion process.
Conducts internal processing platform configuration tasks for implementation and maintenance of business for Appeal and Grievance clients, including timers, letters, reason codes, HiTrust audits, and system access.
Demonstrates system tools to internal and external groups when necessary.
Monitors and tracks vendor activities related to productivity, quality, and reporting.
Maintains confidentiality of all member, provider, client, and proprietary information.
Monitors and reports all information related to Performance Guarantees.
Performs transactions in relevant MedImpact systems with competency.
Stays knowledgeable regarding company policies, procedures, and current departmental developments.
Qualifications
B.S./B.A. and 3+ years’ experience or equivalent combination of education and experience.
Advanced knowledge of MS Office, including Word, Excel, PowerPoint, Visio, and Outlook. Experience using multiple business software applications is required.
Advanced working knowledge of key business applications such as MedOptimize, MedAccess, and other applicable tools preferred.
Current and unrestricted State Pharmacy Technician License required; National Pharmacy Technician certification preferred.
Strong interpersonal skills with the ability to establish and maintain effective business relationships with clients and internal staff.
Experience with business process management and business rules management applications is strongly preferred.
Benefits
Medical / Dental / Vision / Wellness Programs
Paid Time Off / Company Paid Holidays
Incentive Compensation
401(k) with Company match
Life and Disability Insurance
Tuition Reimbursement
Employee Referral Bonus
Work Location & Schedule This full‑time, non‑exempt position is based at the San Diego Headquarters. The role requires occasional travel to local conferences and meetings. Regular office hours are Monday through Friday, 8:00 a.m. to 5:00 p.m., with the flexibility to work nights, weekends, or holidays as needed to meet business requirements.
Equal Opportunity Employer, Male/Female/Disabilities/Veterans
To explore all that MedImpact has to offer, please submit your resume to www.medimpact.com/careers
#J-18808-Ljbffr