Grievance Coordinator

Pay Plan Title: Coordinator

Working Title: Grievance Coordinator

Cost Center: 6400/Appeals & Grievances

Position Number: 91442

FLSA Status: Exempt

Posting Salary Range: $56,270 - $69,898

Office Location: Remote within North Carolina

POSTING DETAILS:

Make an Impact

Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.

Why Work for Us ?


Trillium believes that empowering others begins with supporting our team. We offer our employees:

• A collaborative, mission-driven work environment
• Competitive benefits and work-from-home options for most positions
• Opportunities for professional growth in a diverse inclusive culture

Every day, our work changes lives - from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.

If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!

What We're Looking For

Trillium Health Resources has a career opening for a Grievance Coordinator to join our team! The Grievance Coordinator is responsible for maintaining and coordinating grievance and complaints. Coordinators are responsible for providing support to members and recipients, providers and other callers seeking to file a concern; monitoring and maintaining accurate grievance policies and procedures based on State and Federal guidelines, NCQA standards and other measures; and maintaining and reporting grievance; and complaint statistics. Additional duties are needed to support the grievance and complaint process.

On a typical day, you might:

• Evaluate/investigate the circumstances of the grievance/complaint, which includes interacting with callers to gather information regarding their concern, collaboration with other internal Trillium departments to help gather information and documents for the investigation, and document in the grievance/complaint module. Interfaces with providers and external entities, as required, to resolve grievances and complaints. Uses professional discretion to determine whether allegations contained in grievances or complaints violate established rules or policies and helps determine what is an appropriate response to the contents of complaints or grievances.
• Maintain and adjudicate member and recipient grievances and complaints in a timely manner, ensuring notification letters are updated and sent to the grievant/complainant accurately and timely based on the most current formats and timelines as established by State and Federal regulations.
• Maintain and update the grievance module, spreadsheets and Trillium's on-line grievance/complaint submission portal to help track, and report on grievance/complaint data for NCQA, EQR and State Requirements as well as gather information for the Compliance Committee.
• Establish and ensure grievances and complaint files are maintained in accordance with 42CFR and contractual and accreditation standards.

Employee Benefits:

Trillium knows that work/life balance is essential. That's why we offer:

• Typical working hours: 8:30 am - 5:00 pm; flexible work schedules available for some positions with management approval.
• Work-from-home options available for most positions
• Health Insurance with no premium for employee coverage
• Flexible Spending Accounts
• 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
• NC Local Government Retirement Pension (defined-benefit plan)
• 401k with 5% employer match and immediate vesting
• Public Service Loan Forgiveness (PSLF) qualifying employer
• Quarterly stipend for remote work supplies

Qualifications

Required:

• High School Diploma/GED and six (6) years' experience working with the adult mental health, developmental disabilities or substance use population or field; OR
• Associate's degree and minimum four (4) years' experience working with the adult mental health, developmental disabilities or substance use population or field; OR
• Bachelor's degree and minimum two (2) years' experience working with the adult mental health, developmental disabilities or substance use population or field; OR
• Equivalent combination of education/experience.
• Must have a valid driver's license.
• Must reside within North Carolina.
• Must be able to travel within catchment as required.

Preferred:

• Experience providing crisis intervention or crisis response to individuals within the mental health, developmental disabilities or substance abuse population.

Deadline for Application: August 4,View email address on click.appcast.io:59pm

How to Apply

To be considered, submit your application and resume through our ADP Career Center. Your resume must include:

• Employer name, dates of service (month/year), average hours worked per week, and essential job duties
• Education details (degree type, date awarded, institution, field of study)
• Licensure/certification information, if applicable

After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You'll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.

Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.

Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.

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