Senior Quality Care Specialist
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Job Location:
Columbia, IN - USA
Monthly Salary:
Not Disclosed
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
What will your job look like
The Senior Quality of Care Specialist acts as a resource in assisting the operations as well as working closely with leaders to achieve individual departmental and company objectives. The Senior Quality Care Specialist will be responsible for supporting and working with the Resolution Specialists.
Location: 55 M Street SE Suite 520 Washington DC 20003
What youll do:
- Coordinate responses to complaints/grievances to ensure high quality of care for Washington DC beneficiaries including managing the dedicated telephone line
- Build out and maintain the initial notification process for incidents and accidents
- Manage the DC Quality Care email box to ensure receipt of grievances/complaints
- Manage escalated complaints
- Manage and ensure timely compliant resolutions of beneficiary issues
- Continuously educate employees on new processes and procedures
- Ensure beneficiary concerns are addressed which may require additional solution-based initiatives
- Provide operational improvement recommendations to Leadership
- Provide hands-on training as needed
- Other duties as assigned
What youll need:
Experience Education & Certifications:
- A bachelors degree in either the following: Healthcare administration public health business administration social work or related field
- Minimum of five years complaint resolution experience
- Experience with root cause analysis case tracking reporting and regulatory compliance
- Experience in complaints grievances management appeals and member services within healthcare managed care or regulatory environment
Skills:
- Project management skills knowledge of healthcare Medicaid programs and leadership experience
- Ability to identify and respond to customer needs and circumstances
- Knowledge of contract/client requirements
- Ability to handle confidential information in a professional manner
- Ability to acquire and maintain in-depth knowledge of department process and procedures
- Exemplary communications skills
- Strong leadership skills
- Knowledge of MTM protocols preferred
- Ability to maintain high level of confidentiality
- Moderate to advanced knowledge of Microsoft applications including Word Excel Access; PowerPoint
- Knowledge of Medicaid grievance and appeal processes and relevant federal/state regulations
Whats in it for you:
- Health and Life Insurance Plans
- Dental and Vision Plans
- 401(k) with a company match
- Paid Time Off and Holiday Pay
- Maternity/Paternity Leave
- Casual Dress Environment
- Tuition Reimbursement
- MTM Perks Discount Program
- Leadership Mentoring Opportunities
Salary Min: $27.66
Salary Max: $32.00
This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the jobs location. We offer competitive pay that varies based on individual skills experience and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more you are welcome to discuss this with us as you move through the selection process.
Equal Opportunity Employer: MTM is an equal opportunity employer. MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local State and Federal law. If you are in need of accommodations please contact MTMs People & Culture.
#MTM
Required Experience:
Senior IC
Key Skills
About Company
Moment To Moment (MTM) Group, is a full service marketing and media agency (including social media, experiential and events) that specializes in fostering emotional connections between client offerings and consumer passions.
