Complaints Investigator Job at Public Consulting Group
Overview:
Complaints Investigator - Technical Assistance Center in Albany, NY
Item 1107
Staffing Solutions Organization LLC (SSO), a wholly owned subsidiary of Public Consulting Group, is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.
The incumbent in this position will assist directors and staff in the Office of Health Insurance Programs (OHIP), Division of Health Plan and Contract Oversight in a broad range of planning, implementation, reporting and evaluation activities within the Division of Health Plan Contract Oversight’s Technical Assistance Center (TAC).
Additional duties include: Research and respond to a wide range of inquiries from consumers and plans; answer hotline calls and respond to queries submitted via eMail Logs and other venues; contribute to the clarification of policies and procedures which may include marketing, enrollment, grievances and appeals, and provider/plan education, and quality monitoring (metrics and compliance); participate in plan compliance, survey and focused-review activities, as appropriate; conduct coding and analysis of raw data to streamline departmental auditing processes and improve provision of consumer service; coordinate with other departments to improve reporting and enrollment processes; and other activities as may be deemed necessary in response to the changing needs of the Division.
Qualifications:
- Bachelor’s Degree in business, management, public administration or closely related field.
- A minimum of two (2) years of professional experience in a health care program that: reimburses for health care services; provides health care services directly; provides health care regulatory oversight: performs quality assurance and interpretation/application of standards of health care; manages health care utilization, or conducts health care coordination activities.
- Strong analytical, research and communication (both written and verbal) skills.
- The ability to work independently in conducting research to support DOH policy
- The ability to function in a team environment.
- The ability to think creatively and strategically.
- Preferred: Experience or knowledge of NYS public health insurance programs (e.g., Medicaid, Managed Care, CHPlus or Health Benefit Exchange.
Employees must follow established work schedules. The usual work schedule is 40 hours per week, Monday through Friday. Normal work hours are 8:00 a.m. to 4:30 p.m. unless otherwise specified by the supervisor, this includes a half hour unpaid lunch break. Total work hours must equal 40 hours per week.
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an e-Verify participant.
Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.
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