Corporate Director of Complaints and Grievances in Coral Gables, FL at Beacon Health Options

Date Posted: 3/27/2020

Job Snapshot

Job Description

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a ‘world-class’ candidate experience from the moment you click ‘Apply’! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Corporate Quality Director of Complaints and Grievances to join our team remotely preferably out of Miami FL, Latham NY or Woburn, MA. The Corporate Quality Director of Complaints and Grievances is responsible for Complaints and Grievances Operations, managing work flows, workloads, and activities to ensure that timely and accurate service standards are met; and, ensure adherence to established policies and procedures regarding the complaints and grievance process in accordance with specific client, state, and accrediting body regulations. This role is accountable for applying principles of quality improvement to analyze patterns of complaints and grievances and address root cause issues to lessen the volume of complaints and improve the member experience. The Corporate Quality Director of Complaints and Grievances will report to the VP of Clinical Quality

What does a typical day look like?

  • Leads the operations of the centralized service for the organization
  • Manages Complaints and Grievance staff working on various contracts across five regions
  • Cross trains staff and builds in a flexible work structure to optimize efficiencies and high quality work
  • Uses data and analytics to assess the effectiveness and productivity of the team, managing a need for a flexible workforce
  • Identifies opportunities for improvement and advises the Quality Team on Quality improvement activities to reduce complaints
  • Develops workplans for implementing interventions toward improving member experience of services
  • Works in conjunction with VP of Performance Measurement of Improvement for identifying measurements to evaluate effectiveness of interventions to improve experience of services
  • Develops auditing system for ensuring quality of complaints and grievances letters, and turnaround times are met
  • Ensures that performance guarantees are met for all clients based on variable turnaround time standards
  • Applies business operations methodologies and best practices like Toyota Production Systems to improve performance and ensure compliance with quality standards
  • Identifies area of risk and develops corrective action plans
  • Manage and advise the organization on development and maintenance of an effective complaints and grievance process and system consistent with plan policy and stated goals
  • Provides regular trainings and staff development
  •  

What you Contribute?

Education: Master’s Degree or higher in a health related field required

Licensure: N/A

Knowledge, Skills & Abilities:

  • 3-5 years of Complaint and Grievance experience
  • 5 years of management experience
  • 3 year managed care experience
  • Strong interpersonal skills including coaching staff, handling conflict resolution,
  • Must have strong knowledge of managed care reporting, e.g. HEDIS, QARR, Star Measures, Quality Incentive Measures, and various regulatory reports
  • Accreditation experience is required

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original thinkers.
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & wellbeing incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

Click below on “Apply for this Position” to create a profile and apply for the position

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

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from #GD

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