Patient Relations Lead - Care Quality & Resolutions

UnitedHealth Group; Worcester (MA); Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group is seeking a Patient Relations Specialist in Massachusetts to lead the handling of escalated patient complaints across the organization and coordinate investigations with regulatory agencies. This role supports quality and service excellence and provides training for staff on complaint management.

The position requires MA residency, 5+ years in healthcare customer service, and the ability to work remotely per policy. Strong communication and organizational skills are essential.

Qualifications

• 5+ years of healthcare member/customer/patient service experience.
• Experience using healthcare tools and EMR systems.
• Excellent written and verbal communication with prompt complaint responses.

Responsibilities

• Serves as organizational resource for service line leadership on difficult patient issues.
• Independently evaluates courses of action to resolve complex matters and presents recommendations.
• Coordinates investigation of complaints from patients and regulatory agencies; handles CEO/CMO feedback and coordinates investigations and responses.
• Utilizes initiative to address patient concerns and guides filing managers.
• Trains and supports staff on filing patient concerns and uses the reporting system to track status and outcomes.
• Collaborates with leadership to develop educational programs to raise staff awareness of patient complaints handling.
• Reviews quality concerns with Risk and Quality Management to ensure policy adherence.
• Analyzes patient feedback data and presents improvement recommendations to leadership.
• Communicates best practices across the organization to raise standards for handling complaints.
• Performs additional duties as assigned.

Skills

Customer service

Written communication

Verbal communication

Organizational skills

Problem solving

Tools

Epic EMR

RL Datix

Job description

UnitedHealth Group is seeking a Patient Relations Specialist in Massachusetts to lead the handling of escalated patient complaints across the organization and coordinate investigations with regulatory agencies. This role supports quality and service excellence and provides training for staff on complaint management.

The position requires MA residency, 5+ years in healthcare customer service, and the ability to work remotely per policy. Strong communication and organizational skills are essential.