Appeals and Grievances Quality Assurance and Auditing Specialist II
L.A. Care Health PlanLos Angeles, California, United States
Posted April 7, 2026
67186 - 107498 USD
Full Time
About the Company
L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents.
Job Description
The Appeals and Grievances Quality Assurance and Auditing Specialist II is responsible for developing a successful and cohesive unit with a high level of productivity and focus on implementing, executing, tracking, and assessing targeted and random audits for non-clinical grievance and appeal case documentation.
Requirements
- Assisting the A&G Compliance, Training and QA Manager to develop a successful and cohesive unit with a high level of productivity
- Implementing, executing, tracking, and assessing targeted and random audits for non-clinical grievance and appeal case documentation
- Ensuring A&G Non-Clinical staff is following all Regulatory guidelines, internal P&Ps, Desktop Procedures, in a consistent and accurate manner
- Monitoring A&G Specialists and Lead Intake performance against key performance indicators and recognizing trends that require individual or group retraining
Benefits
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)