Role OverviewThe Complaint and Grievance Process Administrator oversees the Medicaid Division’s complaint process for OHP members and providers. This position leads efforts to monitor compliance with federal and state requirements, identify and analyze complaint trends, and support quality improvement initiatives that strengthen accountability and member experience.
What You Will Do
The role ensures alignment of complaint processes across OHA and ODHS programs, and provides training, guidance, and technical assistance to internal and external partners. It also represents the division by communicating policy, program, and regulatory information to legislators, state and federal partners, community organizations, and other partners.
Why It Might Be a Fit
This position will collaborate with diverse populations most harmed by social injustice and inequities and will demonstrate the ability to build and steward positive, collaborative and partnership-based relationships with diverse community groups including communities of color, immigrant groups, the disability and neurodivergent communities, veterans, older adults, individuals identifying as LGBTQIA2S+ and other communities that have been traditionally marginalized.
Requirements
- Bachelor's Degree in Business or Public Administration, Behavioral or Social Sciences, Finance, Political Science or any degree demonstrating the capacity for the knowledge and skills
- Four years professional-level evaluative, analytical and planning work
- Experience supporting the development, implementation, oversight, or evaluation of complaint, grievance, appeals, quality assurance, or compliance-related programs
- Knowledge of health services delivery systems, particularly the Oregon Health Plan (OHP), Medicaid administration, Coordinated Care Organizations (CCOs), health plans, healthcare providers, or other complex health and human services systems
- Knowledge of federal and state laws, regulations, and compliance requirements related to Medicaid, grievance and appeals processes, quality assurance, or consumer protections
- Experience evaluating and synthesizing quantitative and qualitative data to identify trends, assess program performance, monitor outcomes, and support policy, operational, or quality improvement decisions
- Experience leading or supporting continuous quality improvement, performance improvement, or process improvement initiatives
- Ability to foster collaboration and build effective working relationships across agencies, health plans, providers, advocacy organizations, community partners, and individuals with lived experience
- Strong oral and written communication skills across a variety of forums
- Demonstrated project management experience
Benefits
- Excellent, low-cost medical, vision, and dental coverage for you and your family
- Optional benefits like life insurance, disability coverage, deferred compensation, and FSA options for health and childcare
- Generous paid time off: 11 holidays, 3 personal days, monthly sick leave, and vacation accrual starting at 8 hours/month
- Potential eligibility for the Public Service Loan Forgiveness Program
- Retirement security through Public Employees Retirement System (PERS)/Oregon Public Service Retirement Plan (OPSRP)
- Training and development opportunities to grow your career with the State of Oregon
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