Lead Compliance Investigator

Americare

$75K — $95K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree preferred
  • 5+ years of health care experience preferred
  • 3+ years in home care, compliance, quality management, or investigations preferred
  • Knowledge of Medicare, Medicaid, grievance procedures, patient rights, and complaint resolution
  • Ability to exercise initiative and discretion in sensitive matters
  • Strong analytical and investigative skills
  • Effective collaboration with diverse staff levels

Responsibilities

  • Plan and develop grievance investigation processes
  • Implement oversight for grievance resolution compliance
  • Ensure adherence to Medicare and Medicaid regulations
  • Conduct investigations into grievances and complaints
  • Collaborate with cross-functional teams for timely resolution
  • Analyze grievance data and prepare reports
  • Enhance stakeholder understanding of grievance procedures

Benefits

  • Comprehensive medical, dental, and vision coverage
  • 401K plan with company matching
  • Supportive management team
  • Robust time off policies including cultural holidays and personal days
  • Employee discounts on events and services
Full Job Description
Job Description:

The Lead Grievance Investigator is an essential component of the CHHA team. The Lead Grievance Investigator plans, develops, implements, and oversees the Agency's grievance investigation and resolution processes to ensure compliance with Medicare, Medicaid, federal, state, and local regulations, as well as Agency policies and procedures.

What we offer:
  • Comprehensive benefits including medical, dental, and vision.
  • 401K plan with company match
  • Supportive Management team
  • Robust time off including vacation, sick, personal, floating holiday, Cultural Heritage Day and your birthday off!
  • Employee discount program on events, movie tickets, mobile phone plan discounts and more


What we ask for:
  • Bachelor's Degree preferred.
  • Five (5) or more years of health care experience, preferred.
  • Three (3) or more years of experience in home care, compliance, quality management, or investigations, preferred.
  • Demonstrated knowledge of Medicare, Medicaid, CHHA grievance, patient rights, and complaint resolution requirements.
  • Ability to exercise initiative, sound judgment, and discretion in sensitive matters.
  • Strong analytical, investigative, and problem-solving skills.
  • Ability to work effectively with staff at all levels and to enlist cooperation to achieve timely and effective grievance resolution


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