Job Summary

• The Senior Quality of Care Specialist will coordinate responses to complaints and grievances to ensure high quality of care for Washington DC beneficiaries.
• Responsibilities include managing escalated complaints, ensuring timely resolutions, and educating employees on new processes and procedures.
• The company offers a comprehensive benefits package including health and life insurance, 401(k) with match, paid time off, and tuition reimbursement.

Matching Summary

Salary

Base: $27.66 - $32.00; Bonus/Equity: Not specified; Benefits: Health and Life Insurance Plans, Dental and Vision Plans, 401(k) with a company match, Paid Time Off and Holiday Pay, Maternity/Paternity Leave, Tuition Reimbursement, MTM Perks Discount Program

Skills & Requirements

Key Requirements

• Bachelor's degree in 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
• Project management skills
• Knowledge of Medicaid grievance and appeal processes and relevant federal/state regulations

Work Rights