Medical Compliance Review Liaison

Job Description

Job Description

Description

The successful candidate will be responsible for overseeing grievance and appeal reviews, as well as conducting cultural and linguistic reviews for our subcontractors to ensure alignment with our commitment to diversity and inclusion. This role will provide support to department on promoting health equity within our organization and in the community, ensuring fair and just access to healthcare services for all members.

Essential Duties and Responsibilities

Conduct thorough reviews of grievances and appeals submitted by members to ensure compliance with regulatory requirements and company policies

Ensure timely trainings for practitioners pertaining to grievances that are determined to be discriminatory

Evaluate the cultural and linguistic competency of subcontractors and provide recommendations for improvement to enhance service delivery to diverse populations.

Monitors accreditation, contractual, legal, and regulatory requirements for cultural and linguistic services

Collaborate with internal teams to address and resolve member complaints in a timely and efficient manner.

Develop and implement training programs to educate staff and subcontractors on cultural sensitivity and effective communication strategies.

Maintains department files for auditing purposes (hard and soft copies) per instruction.

Provides support to champion health equity initiatives within the managed care system to address disparities in healthcare access and outcomes.

Other duties as assigned

Additional Skills & Qualifications

Strong, effective oral and written communication skills. Ability to work with ethnically and culturally diverse populations. Requires patience and ability to work with people of all levels of understanding and education

Experience Level

Intermediate Level

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This is a Contract position based out of Fairfield, CA.

The pay range for this position is $40.00 - $43.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a fully onsite position in Fairfield,CA.

This position is anticipated to close on Aug 6, 2026.

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.