• Complaints and Grievances Program Manager - THPG

    Texas Health Resources (Dallas, TX)


    Complaints and Grievances Program Manager - THPG

     

    _Texas Health Physicians Group is looking for a top skilled_ Complaints and Grievances Program Manager _. Is that you?_

     

    Work location: Currently remote however will work on site occasionally. Physical address 612 E Lamar Blvd. Arlington, TX

     

    Work hours: Full Time (40 Hours); Day Shift; Monday - Friday, 8:00 AM - 5:00 PM.

    Department highlights:

    + Remote work environment allows for flexible schedule.

    + Work life balance is a priority

    + Opportunity to learn industry leading compensation software

    + Wide scope of contracting types expands your compensation experience

    + Opportunities for growth within the organization

    What You Will Do:

    Receiving, documenting, and addressing patient complaints and concerns.

     

    Implementing a standardized process for timely investigation and resolution.

     

    Collaborating with physicians, clinics staff, and legal teams to ensure compliance.

     

    Providing data-driven insights to leadership to identify systemic issues and opportunities for

     

    improvement

     

    Manage the feedback on RLts daily acting as the entity?s expert resource in complaint & grievance

     

    processes and keeps abreast of trends in the industry and regulatory standards.

     

    Responsible for ensuring the organization is compliant with new and revised national, state, and local

     

    healthcare requirements and patient safety associated laws, statutes, community standards and laws.

     

    Develop and implement strategies to create and maintain a grievance process and event classification program.

     

    Oversee management of classification, event reporting module, develop standards of performance, and

     

    initiate recommendations based on findings.

     

    Monitor and participate (when necessary) in Department of State Health Services- CMS surveys

     

    associated with grievance events.

     

    Evaluate trends on grievance events for severity, frequency, classification, and reports as necessary to

     

    appropriate THPG leadership, committees, and personnel.

     

    Utilize industry benchmarking to compare appropriate data, support system initiatives, and support

     

    evidenced-based practices.

     

    Support and manage policies related to complaints/grievances.

     

    Manage Grievance Events related to clinical care

     

    Identify and address patient safety risks initiated from a C&G

     

    Grievances may often contain embedded patient safety concerns that may not be immediately

     

    evident. A structured review process helps uncover these risks, enabling timely intervention

     

    Manage Emotional Harm events and correlate C&G and Risk emotional harm opportunities.

     

    Responsible for PDSA KPM for C&G

     

    Collaborative team with approach to ensure that grievances are evaluated from multiple

     

    perspectives and that responses are coordinated and transparent

     

    Review for opportunities across various patient input points (C&G, safety events, CORS/ PARS,

     

    TMB complaints, insurance inquiries, etc.)

    Supports data driven decision making and action planning 95%

    Other duties as assigned. 5%

     

    * What You Need:

    * Education

     

    Bachelor's Degree Statistics, public health, health administration, business, or related field. 4 Years Relevant work experience in lieu of a degree. Req And

     

    Master's Degree Statistics, public health, health administration, business, or related field. Pref

    Experience

    7 Years Healthcare management or complaint management, with 5 years of direct patient advocacy or complaint management. Req

    **Education** Bachelor's Degree Statistics, public health, health administration, business, or related field. 4 Years Relevant work experience in lieu of a degree. Req And

     

    Master's Degree Statistics, public health, health administration, business, or related field. Pref **Experience** 7 Years Healthcare management or complaint management, with 5 years of direct patient advocacy or complaint management. Req **Skills** Effective communicator with proven experience in working with inter-professional teams to achieve positive

     

    outcomes. Excellent verbal, written, and presentation skills are required to ensure clear communication with

     

    THPG senior leadership and staff. Displays good organizational skills and is able to manage multiple projects,

     

    meeting agreed upon timelines. Work independently and intentionally. Able to set direction, provide guidance,

     

    build consensus and develop inter-professional teams to address identified risk. Ability to acquire and review

     

    multiple data sources and provide detailed analysis to the appropriate Business Unit. Must have advanced MS

     

    Office (Word, Excel, PowerPoint) experience. This position requires expertise and understanding of healthcare

     

    regulatory agency standards and national patient safety goals. The incumbent must be comfortable with

     

    managing multiple projects simultaneously. **Supervision** Individual Contributor **ADA Requirements** Working Indoors 67% or more **Physical Demands** Light Work

     

    Texas Health requires a resume when an application is submitted.Employment opportunities are only reflective of wholly owned Texas Health Resources entities.

     

    We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.