Why BayCare? At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence. **Summary:** + Manages intricate grievances, collaborating closely with healthcare providers and members to resolve disagreements, and ensuring adherence to regulatory requirements. + Triage, plan, and execute intake of Appeals and Grievance submissions. + Keeping track of deadlines, ensuring all necessary documentation is completed and filed appropriately, and communicating effectively with all parties involved. + Provide reports on the status of grievances and provide updates to management. + Adhere to HIPAA requirements, guidance on documentation gathering including naming conventions and security protocols. + Requires deep understanding of gap closure specifications. **Minimum Qualifications:** Education/Experience: + 3 years Customer Service (or similar) within a healthcare or insurance environment with HS/GED; Or + 1 year - Customer Service (or similar) within a healthcare or insurance environment with an Associates with an Associates **Facility:** BayCare Health System **Location:** **Park Place** **Status:** **Full Time, Exempt: No** **Shift Hours:** **8:00 AM - 4:30 PM** **Weekend Work:** **Occasional** **On Call:** **No** How often will this team member be working remotely? Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Grievance Specialist-Health Plan **Location** Clearwater:Park Place | Business and Administrative | Full Time **Req ID** null