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Vp Case Resolution Specialist Jobs (NOW HIRING)

Archer Systems

Lien Resolution Specialist

Austin, TX · On-site

The Case Analyst ensures all cases are progressing towards completion and all duties ARCHER is ... Austin, TX (ON SITE) JOB RESPONSIBILITIES • Identify data required for lien resolution and ...

Archer Systems

Compass Case Specialist

Austin, TX · On-site

The Case Specialist is integral to our Compass lien resolution operation. This individual will prepare, send, process, and receive large volumes of correspondence exchanged with various agencies and ...

LeafHome

Resolution Specialist

Hudson, OH · On-site

S. and Canada, with continued expansion Position Summary The Resolution Specialist is responsible ... Collaborate with internal and external teams to gather all necessary data for case analysis and ...

LeafHome

Resolution Specialist

Hudson, OH

S. and Canada, with continued expansion Position Summary The Resolution Specialist is responsible ... Collaborate with internal and external teams to gather all necessary data for case analysis and ...

Gametime United

Vice President, Operations

OR · On-site +1

We're hiring a Vice President, Operations to own the full arc from post-purchase to resolution, and ... You own the relationship with the product org on post-purchase and build the prioritization case ...

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How much do vp case resolution specialist jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for vp case resolution specialist in the United States is $20.76, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $23.32 per hour, depending on experience, location, and employer.

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Vp Case Resolution Specialist jobs near you

Z TEMP - Grievance Resolution Specialist (Provider Resolution)

Orange, CA

Partners in Diversity
See more jobs at Partners in Diversityexternal

$25.87 - $38.80/hr

Temporary

Re-posted 2 days ago

Key responsibilities

  • Assist in carrying out department responsibilities related to grievance and appeal cases, including gathering pertinent information and supporting case discussions.

  • Evaluate case details, propose recommendations or make decisions, and ensure final disposition aligns with policies.

  • Develop resolution letters and correspondence to members and providers, and communicate with internal and external customers to facilitate timely review and resolution.

Job description

Job Title: Z TEMP - Grievance Resolution Specialist (Provider Resolution)
Position Information:
  • Department: Grievance & Appeals
  • Compensation: $25.87 - $38.80 DOE 
  • Work Arrangement: Full Office 
  • Work Schedule: Monday through Friday; 8:00 a.m. to 5:00 p.m.
  • Expected Assignment Duration: up to six (6) months
Duties & Responsibilities:
  • 90% - Program Support 
    • Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
    • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
    • Maintains adequate information in Health’s systems and ensures data collection, summarization, integration and reporting, which includes case creation and management and events/activity tracking.
    • Gathers pertinent information regarding the grievances and appeals received, including member or provider concerns, supporting information related to initial decision-making, new information supporting the grievance or appeal or supplemental information required to evaluate grievances and appeals within regulatory requirements.
    • Coordinates and participates in case discussions with operational experts to result in a final case disposition as needed.
    • Evaluates case details, proposes recommendations or makes decisions as applicable and ensures the organization’s decision is implemented according to the Grievance and Appeals policies and case resolution.
    • Develops resolution letters and correspondence to members and providers.
    • Communicates with internal and external customers to ensure timely review and resolution of grievances or appeals.
    • Contacts appropriate parties to request and obtain missing information and supporting documentation or provides education.
    • Reads and interprets provider contracts, Division of Financial Responsibility (DOFR), policies, procedures and instructions.
    • Responds to routine provider inquiries via phone, assisting with provider appeals resolution inquiries.
    • Assists with the health networks’ compliance process.
    • Identifies trends and root causes of issues, proposes solutions or escalates ongoing issues to management.
    • Meets performance measurement goals for Grievance and Appeals Resolution Services.
  • 10% - Other 
    • Completes other projects and duties as assigned.
Minimum Qualifications:
  • High school diploma or equivalent PLUS 1 year of experience with Provider Dispute Resolution in Medicare and Medi-Cal in professional, institutional, outpatient, ancillary, coordination of benefits and government cases required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
  • 1 year of experience with Medicare or Medi-Cal provider appeals and denials process required.
  • 1 year of experience in any of the following areas: Grievances and Appeals, Claims Administration, Regulatory Compliance, Customer Service or related field required.
Preferred Qualifications:
  • Associate degree in business, health care administration or related field.
  • Experience in health care practice standards, for both government and commercial plans.
  • Bilingual in English and in one of Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese).
Knowledge & Abilities:
  • Develop rapport and establish and maintain effective working relationships with Health's leadership and staff and external contacts at all levels and with diverse backgrounds.  
  • Work independently and exercise sound judgment.
  • Communicate clearly and concisely, both orally and in writing.
  • Work a flexible schedule; available to participate in evening and weekend events.
  • Organize, be analytical, problem-solve and possess project management skills.
  • Work in a fast-paced environment and in an efficient manner.
  • Manage multiple projects and identify opportunities for internal and external collaboration.
  • Motivate and lead multi-program teams and external committees/coalitions.
  • Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With or Without Accommodations):
  • Ability to visually read information from computer screens, forms and other printed materials and information.
  • Ability to speak (enunciate) clearly in conversation and general communication.
  • Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
  • Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
  • Lifting and moving objects, patients and/or equipment 10 to 25 pounds