Member Grievance Coordinator

Why should you consider a career with Colorado Access? We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP ) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion. Find work/life balance:  We offer PTO, floating holidays, nine company paid holidays, a hybrid work environment, an Employee Assistance Program and a 401K. Be a part of something bigger and make an impact: We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference. Sharpen your skills, learn, and grow: We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend.   What you will do: We are looking for a MEMBER GRIEVANCE COORDINATOR who can help shape our vision and support our mission. Here is what the position will look like. Promptly responds to member grievances, while demonstrating compassion, empathy, respect and customer service. Maintains record of activities through comprehensive documentation within department databases. Responsible for logging, tracking, monitoring, resolving, auditing and reporting of member grievances. Gathers additional information, researches, investigates to facilitate resolution of grievances.  Ensure grievances are resolved in a professional, expeditious manner, and within contractual and regulatory time limits. Identifies potential quality of care issues and directs cases to the Quality Management Department for review as needed. Writes and sends member response letters, and other general correspondence, related to grievances, by following department guidelines, demonstrating appropriateness and utilizing approved template letters.  Recommends and manages improvements to automate processes, improve customer satisfaction and increase efficiencies. Provides internal and external training and education on the Member Grievance process. Ensures the grievance resolution process and daily activities comply with corporate policy and procedure, ADM 203. Monitors grievances for trends and recommends appropriate action. Ensures grievance calls are answered from the grievance phone queue and follows department and company standards.   What you will bring:   Education: High School diploma or equivalent required, or an equivalent combination of education and experience. A bachelor’s degree in Healthcare Administration preferred.   Experience: Requires two years of health care experience. Prefer customer service, eligibility and enrollment, grievance, behavioral healthcare or project management experience. Knowledge, Skills, and Abilities: Knowledge of health care, Colorado Medicaid and managed care preferred. Must have excellent written and verbal communication skills. Must have strong time management skills, strong interpersonal skills and a strong working knowledge of database and spreadsheet programs, particularly Access. Requires the ability to use the grievance process and procedures to effectively facilitate timely quality outcomes. Licenses/Certifications: None   Together we will be: an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization.   Pay, Perks and Benefits at Colorado Access: The compensation for this position is $52,000.00 to $56,000.00 annually and is a non-exempt (hourly) position. Colorado Access has provided a compensation range that represents its good faith estimate of what Colorado Access may pay for the position at the time of posting. Colorado Access may ultimately pay more or less than the posted compensation range. The salary offered to the selected candidate will be determined based on factors such as the qualifications of the selected candidate, departmental budget availability, internal salary equity considerations, and available market information, but not based on a candidate’s sex or any other protected status.   In addition to being part of a mission driven organization serving our community, as an eligible Colorado Access employee, you’ll receive a generous benefits package, that includes: Medical, dental, vision insurance that starts the first day of the month following start date.  Supplemental insurance such as critical illness and accidental injury.  Health care and dependent care flexible spending account options. Employer-paid basic life insurance and AD&D (employee, spouse and dependent).  Short-term and long-term disability coverage. Voluntary life insurance (employee, spouse, dependent). Paid time off Retirement plan Tuition reimbursement (based on eligibility).  Annual bonus program (based on eligibility, requirements and performance).   Where you will work: This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’      We are not able to support out of state employees at this time as we continue to serve our members and community in the metro Denver area and across the beautiful state of Colorado. .

Salary : $52,000 - $56,000