Remote Grievance Resolution Specialist

DETROIT WAYNE Integrated HEALTH Network; Detroit (MI); Remote; USD 52,000 - 72,000; Full time

Job summary

Detroit Wayne Integrated Health Network is seeking a Customer Service Grievance Specialist to ensure compliant management of grievances under local, state, and federal rules. You will oversee inquiries, assist with process development, and collaborate with providers and staff across Wayne County and beyond.

The role emphasizes data reporting, trend analysis, and training modules for staff and contractors, with remote work available and supervision required.

Qualifications

• Bachelor’s degree required in a relevant field such as Social Work, Psychology, healthcare administration, health management, business administration, or conflict resolution.
• Experience with complex cross-functional dispute resolutions or enrollee/member relations is required.
• Knowledge of mental health codes, MDHHS policies and grievance processes is expected.

Responsibilities

• Assists with development of grievance processes per Federal Rules, MDHHS guidelines, Michigan Mental Health Code and policies.
• Provides information, referral, and linkage to customers.
• Oversees telephone and walk-in inquiries and monitors the grievance process for compliance.
• Generates and maintains reporting on grievances and trends for internal and external stakeholders.
• Prepares regular grievance activity reports (weekly, monthly, quarterly, annual).
• Delivers training modules on grievance protocol to staff, providers, enrollees, and families.

Skills

Assessment

Organizational

Analytical

Time management

Report writing

Decision making

Customer service

Communication

Active listening

Multitasking

Prioritization

Written communication

Attention to detail

Investigation

Training

Computer skills

Oral communication

Teamwork

Ethical/confidentiality

Diversity sensitivity

Judgement/Reasoning

Education

Bachelor's degree in Social Work, Psychology, Healthcare Administration, Health Management, Business Administration, Conflict Resolution or related field

Tools

Word

Excel

Access

PowerPoint

Outlook

Teams

Job description

Detroit Wayne Integrated Health Network is seeking a Customer Service Grievance Specialist to ensure compliant management of grievances under local, state, and federal rules. You will oversee inquiries, assist with process development, and collaborate with providers and staff across Wayne County and beyond.

The role emphasizes data reporting, trend analysis, and training modules for staff and contractors, with remote work available and supervision required.