Complaints & Grievances Specialist

About the Role

CBH is a dynamic organization dedicated to providing access to high-quality, accountable care to improve the health and mental wellness of our members. As part of our growth, we are seeking a detail-oriented Complaints & Grievances Specialist to join our team.

Responsibilities

• Review, document, and process all levels of complaints and grievances
• Complete packet for and participate in Fair Hearing
• Address Quality Concerns stemming from complaints and grievances to determine the level of follow-up required (e.g., investigating or tracking)
• Travel is required for this position

Requirements

• Master's Degree in behavioral health, healthcare, or social sciences
• Minimum of 2 years of experience in a managed care or quality management setting
• Knowledge of PA Act 146, Appendix H, and medical necessity criteria
• Thorough knowledge of DBH and DHS systems and services
• Philadelphia residency requirement: must be a current resident or become one within six months of hire
• U.S. work authorization without requiring sponsorship

Qualifications

• Proficient in Microsoft Office applications
• Excellent written and verbal communication skills
• Excellent customer service, training, and facilitating skills
• Strong interpersonal skills

Work Conditions

• Regularly requires walking, standing, stooping, bending, sitting, reaching, pushing, pulling, and/or repetitive wrist/hand movements
• Ability to utilize computers and office equipment
• Regularly works indoors in adequately lighted and ventilated areas with some temperature fluctuations
• Must adapt to continuous changes/demands and be able to travel

Benefits

• Family planning, fertility, and adoption benefits
• 403B retirement plan
• PTO days/sick days
• Wellness program
• Employee assistance program
• Health, dental, and vision insurance
• Medical and prescription drug insurance
• Tuition reimbursement
• Commuter benefits
• Flexible spending

Compensation: $58,300 Yearly Salary