Member Relations Specialist

POSITION SUMMARY

This position assists with the operational management of member complaints with an emphasis on execution, outcomes, continual improvement, and overall functioning of the complaint process and incident reporting. This position also manages Quality Management aspects of Environment of Care including compliance and maintenance of EOC policies and documentation.

ESSENTIAL FUNCTIONS

  1. Receive and address member complaints in a professional and timely manner.
  2. Build a trusting and honest relationship during each member interaction.
  3. Coordinate with agency wide teams to resolve issues and determine next steps.
  4. Provide problem resolution for member complaints.
  5. Maintain data integrity and document compliance related information in an appropriate manner, following TGC processes.
  6. Provide excellent customer service with both internal and external customers.
  7. Point person for Grievance & Appeals.
  8. Assist with Quality-of-Care concerns.
  9. Manage the Incident Reporting process.
  10. Stay informed on regulatory changes.
  11. Ensure an effective system is in place for TGC's incident reporting mechanism and safety concerns.
  12. Address and troubleshoot internal and external complaints.
  13. Develop and manage training curricula related to incident reporting and culture of safety.
  14. Assist with policy process.
  15. Functions as one of the points of contact information regarding quality and safety compliance related issues.
  16. Assist with improvement opportunities related to quality and reporting within the organization.
  17. Coordinate and facilitate the Environment of Care Committee Meeting.
  18. Compile, track, and present all Environment of Care (EOC) and safety data.
  19. Perform other duties as assigned.

EDUCATION/KNOWLEDGE/SKILLS

Required:

  • High school diploma or GED
  • 1-2 years QI experience in behavioral health or a related field
  • Ability to obtain Arizona Fingerprint Clearance Card
  • Excellent verbal and written skills
  • Proficient in Microsoft Office
  • Exemplary customer service skills

Preferred:

Bachelor's degree

Healthcare experience

Knowledge of healthcare regulatory practices/standards

ACCOMMODATIONS

TGC will provide reasonable accommodations for individuals with disabilities, unless it would cause undue hardship. We define reasonable accommodation as any change in the work environment or in the way a job is performed that enables a person with a disability to enjoy equal employment opportunities. We will make a good faith effort to list any special requirements in our job descriptions. The physical demands of this position warrant: Sedentary Work Occasionally lifting up to 10 pounds. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time.