Clinical Complaint Investigator in Seven Fields, PA at Beacon Health Options

Date Posted: 2/6/2018

Job Snapshot

Job Description


We are currently seeking a dynamic Clinical Complaint Investigator to join our team at our office in Seven Fields, PA.  The Clinical Complaint Investigator will be responsible for investigating and reporting on all complaints; it requires some participation in a range of quality management activities including adverse incident and quality of care investigations and reporting, audits, data collection, and analysis.

Position Responsibilities:

  • Review member and administrative complaints as defined by contractual requirements including but not limited to:
  • Conduct an in-office or on-site investigation including, but not limited to, the interview of involved staff and inspection of the physical plant, related to the occurrence of a complaint;
  • Interview complainant
  • Review the patient’s chart
  • Summarize the findings
  • Monitor provider compliance with corrective action plan; and
  • Present results of investigation to appropriate committee
  • Follow-up to Quality Management Committee (QMC) or subcommittee recommendations
  • Collaborate as required with senior management and legal counsel in the strategic response to specific complaints
  • Provide ongoing support for preparation to include Contract Readiness Reviews, and all OHMSAS and External Quality Review reporting standards
  • Develop and improve workflows and forms as necessary to ensure the satisfactory operation of the complaint investigation and reporting process. Assist in updating policies and procedure documentation as necessary

Travel required 10-15% of time. Must have a valid and unrestricted driver’s license and reliable transportation.

Position Requirements:

Education: Master’s Degree in social work, psychology, counseling, education (with BHRS and/or drug & alcohol experience), other social service programs or Bachelor’s degree in nursing.

Licensure:  Licensure is preferred in the field of social work (LSW), nursing (RN), or Counseling (LPC) or other related mental health field.

Relevant Work Experience:   A minimum of two years of clinical experience.  Experience in a community mental health setting is strongly desired.

 Knowledge, Skills & Abilities:

  • Must possess critical thinking, interpersonal and problem solving, teamwork and organizational skills
  • Able to multi-task in fast paced environment with competing priorities.
  • Computer literate including intermediate/advance knowledge of Word and Excel


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Beacon Health Options company is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled





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