Complaints and Grievances Program Manager – THPG

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