With a mission centered on accessible, equitable care, this organization employs professionals across managed care, appeals and grievances, utilization management, claims processing, member services, and administrative support functions all working together to ensure members receive high-quality, compliant healthcare services. This position will provide resolution of complaints in compliance with Centers for Medicare and Medicaid Services (CMS), California Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Managed Risk Medical Insurance Board (MRMIB), and National Committee for Quality Assurance (NCQA) regulatory requirements.