Managing Complaints and Grievances: How do they do it?
Event Date: 4/15/2020
Event Overview
Wednesday, 4/15/2020
1:00 PM CST – 2:00 PM CST (60 minutes)
Hosted by: Quartz Health Solutions and SelectHealth
This event is hosted on our BigMarker platform
Health plans continually struggle with managing member complaints and grievances. What is the most efficient process? Who should be involved? How do we set policies and measure effectiveness? In this webinar, two Alliance member health plans share their best practices and solutions for navigating the complaints and grievance process at their organizations. Some topics that will be covered in this session include:
- Structure, staffing, committees, who is involved
- How the process flows
- Metrics, KPIs and reporting
- Improvement initiatives and learnings
Audience
If you role involves member experience, customer service, quality, compliance, legal, or process improvement, this webinar is for you! In addition, people involved in strategy, finance, sales and marketing and IT would also benefit from this session.
Ask your peers a question or share a resource anytime through the Alliance discussion forum
You can visit the discussion forum and post a question anytime. It's only available to Alliance members, so you question is private and secure. When submitting a question, you can select which topics your question is related to. Individuals who have indicated in their Alliance profile they are interested in those topics and are opted in to discussion forum emails will receive your question. You can also add an attachment to your question or reply, making this tool another great resource for sharing best practices with your peers.
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Documents
Presentation: Managing Complaints and Grievances - SelectHealth
Quartz Health Solutions and SelectHealth share their best practices for handling the challenging process for complaints and grievances management. The process flow, who is involved, measures and reporting are covered in addition to innovative solutions and learnings.
Presentation: Managing Complaints and Grievances - Quartz Health Solutions
Quartz Health Solutions and SelectHealth share their best practices for handling the challenging process for complaints and grievances management. The process flow, who is involved, measures and reporting are covered in addition to innovative solutions and learnings.
Recording: Managing Complaints and Grievances
Quartz Health Solutions and SelectHealth share their best practices for handling the challenging process for complaints and grievances management. The process flow, who is involved, measures and reporting are covered in addition to innovative solutions and learnings.
Attendees
Below is a list of all delegates registered to date for this event
- Robyn Anderson
- ALLIANCE MEMBER
- Delegation Oversight Auditor at Health Alliance Plan (HAP)
- Oscar Arrieta Corona
- ALLIANCE MEMBER
- Appeals Specialist Supervisor at Quartz Health Solutions
- Nicole Beadle
- ALLIANCE MEMBER
- Manager, Medicare Compliance at Paramount Health Care
- Stephanie Belue
- ALLIANCE MEMBER
- Director of Quality Assurance & Privacy Officer at Alliant Health Plans
- Stephanie Blue
- ALLIANCE MEMBER
- Appeals & Complaints Director at Sentara Health Plans (Optima)
- Kristie Breunig
- ALLIANCE MEMBER
- Vice President, General Counsel and Secretary at Quartz Health Solutions
- Karen Brunton
- ALLIANCE MEMBER
- Project Manager at Medical Associates Health Plans
- Katherine Campbell
- ALLIANCE MEMBER
- Project Specialist at CommunityCare
- Mary Canton
- ALLIANCE MEMBER
- QI Project Coordinator at Samaritan Health Plans
- Marty Cerier
- ALLIANCE MEMBER
- Director Regulatory Audits and Investigations at Health Alliance Plan (HAP)
- Tammy Chadd
- ALLIANCE MEMBER
- Compliance Manager at IU Health Plans
- Star Christensen
- ALLIANCE MEMBER
- Medicare Product Manager at SelectHealth
- Martha Cisneros
- ALLIANCE MEMBER
- Director, Member Outreach & Engagement at Valley Health Plan
- Carol Cordoba
- ALLIANCE MEMBER
- Quality Assurance Business Analyst, Mbr. Engagement at AvMed
- Brian Crocker
- ALLIANCE MEMBER
- IS Business Systems and QAA I at Network Health
- Linda Cummings
- ALLIANCE MEMBER
- Lead Clinical Quality Examiner at MetroPlusHealth
- Corinna Daunt
- ALLIANCE MEMBER
- Product Consultant at Health Alliance Plan (HAP)
- Jodi Digmann
- ALLIANCE MEMBER
- Medicare Compliance Analyst at Medical Associates Health Plans
- Terry Donnenwirth
- ALLIANCE MEMBER
- Compliance Coordinator at SummaCare
- Cynthia Farrelly
- ALLIANCE MEMBER
- Accreditation and Quality Program Manager at Capital District Physicians' Health Plan (CDPHP)
- Patricia Frederick
- ALLIANCE MEMBER
- Internal Audit Manager at Johns Hopkins Health Plans
- Karen Frey
- ALLIANCE MEMBER
- Process Improvement Analyst at Quartz Health Solutions
- Dinita Galvez
- ALLIANCE MEMBER
- Quality Improvement Manager at Health Alliance Medical Plans
- Julia George
- ALLIANCE MEMBER
- Compliance Manager at Sentara Health Plans (Optima)
- Stacy Grein
- ALLIANCE MEMBER
- Compliance Specialist at Denver Health Medical Plan
- Jessica Grenier
- ALLIANCE MEMBER
- Director, Claim Operations at Community Health Options
- Kyle Hayden
- ALLIANCE MEMBER
- Management Analyst at Valley Health Plan
- Kristal Hemmersbach
- ALLIANCE MEMBER
- Sales Operations Specialist at Quartz Health Solutions
- Jennifer Hendricks
- ALLIANCE MEMBER
- Supervisor, QI at CommunityCare
- Kimberly Jorgensen
- ALLIANCE MEMBER
- Medicare Operational Consultant at SelectHealth
- Peggy Kidd
- ALLIANCE MEMBER
- Manager, Quality Assurance and Member Relations at AvMed
- Gretchen Lagassee
- ALLIANCE MEMBER
- Manager, Claims Operations at Community Health Options
- Amanda Lay
- ALLIANCE MEMBER
- Supervisor, Grievance and Appeals at CommunityCare
- Jennifer Le
- ALLIANCE MEMBER
- QI Coordinator at Valley Health Plan
- Michelle Logan
- ALLIANCE MEMBER
- Clinical Healthcare Coordinator at CommunityCare
- Lisa Mandic
- ALLIANCE MEMBER
- Medicare Advantage Customer Service Supervisor at Community Health Plan of Washington
- Lee Manzo
- ALLIANCE MEMBER
- Compliance Analyst at FirstCarolinaCare Insurance Company
- Damenica Mitchell
- ALLIANCE MEMBER
- Supervisor, Grievance and Appeals at CommunityCare
- Mark Mixer
- ALLIANCE MEMBER
- Chief Executive Officer at Alliant Health Plans
- Karen Moncada
- ALLIANCE MEMBER
- Regulatory Compliance & Accreditation at AvMed
- Jonathan Moody
- ALLIANCE MEMBER
- Director of ACA Products and Government Affairs at Quartz Health Solutions
- Adrienne Neaderhiser
- ALLIANCE MEMBER
- Director, Member Experience Design at Presbyterian Health Plan
- Janine Nunez
- ALLIANCE MEMBER
- Regulatory Compliance Coordinator at AvMed
- Kari Pace
- ALLIANCE MEMBER
- Clinical Documentation Improvement Nurse-Risk Adjustment/Quality Management at Medical Associates Health Plans
- Kelly Paul
- ALLIANCE MEMBER
- Auditor at SelectHealth
- Leslie Pels-Beck
- ALLIANCE MEMBER
- Chief Operations Officer at Sharp Health Plan
- Jana Pennington
- ALLIANCE MEMBER
- Risk Adjustment Analytics Manager-Coding at Saint Luke's Health System
- Nicole Pugh
- ALLIANCE MEMBER
- Manager Grievance and Appeals at CommunityCare
- Jennifer Ramirez
- ALLIANCE MEMBER
- Program Manager Member Appeals & Grievances at Valley Health Plan
- Anna Rasmussen
- ALLIANCE MEMBER
- Strategy and Product Lead at Network Health
- Dana Renicker
- ALLIANCE MEMBER
- Medicare Education Specialist at SummaCare
- Celeste Richards
- ALLIANCE MEMBER
- Chief Operating Officer at Alliant Health Plans
- Pete Roverud
- ALLIANCE MEMBER
- VP of Strategy and Development at PreferredOne
- Petrina Russell
- ALLIANCE MEMBER
- Compliance Auditor at FirstCarolinaCare Insurance Company
- Janice Sawyer
- ALLIANCE MEMBER
- Senior Regulatory Auditor at Health Alliance Plan (HAP)
- Barb Smith
- ALLIANCE MEMBER
- Clinical Review Coder - Avera Health at Avera Health Plans
- Katie Studer
- ALLIANCE MEMBER
- Director, Customer Experience at Avera Health Plans
- Elaine Taylor
- ALLIANCE MEMBER
- Compliance Consultant at IU Health Plans
- Jill Thomas
- ALLIANCE MEMBER
- Clincal Auditor at Geisinger Health Plan
- Velia Thompson
- ALLIANCE MEMBER
- Quality Improvment Clincial Coordinator at Providence Health Plan
- Elizabeth Trigos-Salinas
- ALLIANCE MEMBER
- Senior Healthcare Program Analyst at Valley Health Plan
- Benjamin Trumbull
- ALLIANCE MEMBER
- Medicare/ Pharmacy Compliance Analyst at Health Alliance Medical Plans
- Inez Valdez
- ALLIANCE MEMBER
- VHP Member Services Supervisor at Valley Health Plan
- Tonya Vinyard
- ALLIANCE MEMBER
- Grievance and Appeals Coordinator at CommunityCare
- Vivian Williams
- ALLIANCE MEMBER
- Manager of Care Management at Health New England
- Cassandra Wood
- ALLIANCE MEMBER
- Quality Assurance Accreditation Administrator at Alliant Health Plans
- William Yee
- ALLIANCE MEMBER
- Assistant Compliance Counsel at Central Health Plan of California
- Lauren Zahn
- ALLIANCE MEMBER
- Process Eng at Johns Hopkins Health Plans
- Holly Zorz
- ALLIANCE MEMBER
- Quality Improvement Team Lead, Medicare at Paramount Health Care
Speakers
- Kelly Paul
Auditor at SelectHealth
click here for full people profile
- Kate Salveson
Appeals Specialist Manager at Quartz Health Solutions
click here for full people profile