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We are currently seeking a Temporary Grievance Resolution Specialist (Provider Resolution) to join our team and support our mission of delivering high-quality, member-focused healthcare services. This position plays a key role in coordinating the Grievance and Appeals resolution process , responding to verbal and written inquiries from both members and providers related to eligibility, benefits, contract administration, claims, pharmacy, vision, and utilization management decisions. Job Title : Temporary Grievance Resolution Specialist (Provider Resolution) PAY Range : $25 / HR - $30 / HR Schedule : Monday Friday | 8 : 00 AM 5 : 00 PM Location : Orange, CA 92868 Duration : Temporary Assignment for 6 months Key Responsibilities Include : Investigate and resolve provider grievances and appeals Collaborate with internal teams (Customer Service, Provider Relations, Pharmacy, Medical Management) Review contracts, DOFRs, and policies to assess case details Draft provider / member resolution letters and document case outcomes Maintain accurate records in Health's systems Ensure regulatory compliance and timely resolution Minimum Qualifications : High school diploma or equivalent 1 year of experience in Medicare / Medi-Cal provider appeals and denials Experience in Grievances and Appeals, Claims, Compliance, or related areas Strong communication, organizational, and case management skills Preferred Qualifications : Associate degree in healthcare administration or related field Bilingual in one of threshold languages (e.g., Spanish, Vietnamese, Korean) Familiarity with provider dispute resolution and regulatory standards If you're looking to make an impact in healthcare and bring resolution to complex provider issues in a dynamic and supportive environment, we'd love to hear from you. Please let me know if you're interested, and I will be happy to provide additional information on how to apply. #J-18808-Ljbffr