Senior Quality Care Specialist

MTM Transit•Washington, DC

22d•$28 - $32•Onsite

About The Position

What will your job look like? The Senior Quality of Care Specialist acts as a resource in assisting the operations, as well as working closely with leaders to achieve individual, departmental and company objectives. The Senior Quality Care Specialist will be responsible for supporting and working with the Resolution Specialists. Location: 55 M Street SE, Suite 520 Washington, DC 20003 What you’ll do: Coordinate responses to complaints/grievances to ensure high quality of care for Washington DC beneficiaries, including managing the dedicated telephone line Build out and maintain the initial notification process for incidents and accidents Manage the DC Quality Care email box to ensure receipt of grievances/complaints Manage escalated complaints Manage and ensure timely compliant resolutions of beneficiary issues Continuously educate employees on new processes and procedures Ensure beneficiary concerns are addressed which may require additional solution-based initiatives Provide operational improvement recommendations to Leadership Provide hands-on training, as needed Other duties as assigned What you’ll need: Experience, Education & Certifications: A bachelor’s degree in either the following: Healthcare administration, public health, business administration, social work or related field Minimum of five years’ complaint resolution experience Experience with root cause analysis, case tracking, reporting, and regulatory compliance Experience in complaints, grievances management, appeals, and member services within healthcare, managed care or regulatory environment Skills: Project management skills, knowledge of healthcare, Medicaid programs, and leadership experience Ability to identify and respond to customer needs and circumstances Knowledge of contract/client requirements Ability to handle confidential information in a professional manner Ability to acquire and maintain in-depth knowledge of department process and procedures Exemplary communications skills Strong leadership skills Knowledge of MTM protocols preferred Ability to maintain high level of confidentiality Moderate to advanced knowledge of Microsoft applications, including Word, Excel, Access; PowerPoint Knowledge of Medicaid grievance and appeal processes and relevant federal/state regulations What’s in it for you: Health and Life Insurance Plans Dental and Vision Plans 401(k) with a company match Paid Time Off and Holiday Pay Maternity/Paternity Leave Casual Dress Environment Tuition Reimbursement MTM Perks Discount Program Leadership Mentoring Opportunities Salary Min: $27.66 Salary Max: $32.00 This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss this with us as you move through the selection process. Equal Opportunity Employer: MTM is an equal opportunity employer. MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law. If you are in need of accommodations, please contact MTM’s People & Culture. #MTM About Us MTM Health is a healthcare and transportation management company whose mission is to partner with clients in developing innovative solutions for accessing healthcare, increasing independence, and connecting community resources in the most cost-effective manner. To achieve this, we leverage our core competencies in managing customer service operations and building provider networks. MTM Health’s five core values guide our employees in providing the highest quality customer experience possible and helping clients achieve their goals: - Respect Individuals - Collaborate to Innovate - Deliver Value - Align with Clients - Act with Integrity Your Potential. Our Mission. At MTM Health, you’re not just part of a team—you’re at the heart of a movement to remove community barriers nationwide. We’re all about breaking the mold with bold ideas, open conversations, and a relentless focus on what matters most: you. Here, collaboration sparks breakthroughs, learning fuels growth, and every voice shapes our future. Together, we thrive, push our limits, and work as team to help you reach your full potential. With consistent Top Workplace and Best Place to Work awards, plus honors for Healthiest Employers, Diversity and Inclusion, Women in Leadership, and top-tier training programs, we’re recognized for creating a culture that empowers you to thrive, innovate, and lead with impact. We invite you to apply for any of our open positions and look forward to providing you an opportunity to develop your career as a member of our team. Don't see your dream job listed? No problem! Introduce yourself by completing this form with your contact information and resume. We’ll keep your details on hand and reach out if a great opportunity opens up that matches your experience. Benefits without Barriers To show appreciation for our staff’s hard work and dedication, MTM offers more than just a paycheck. Our Total Rewards program is all encompassing, offering a wide variety of enticing benefits to ensure our employees and their families are rewarded. Limitless Growth Opportunities At MTM, your growth powers our movement. Our career development programs are designed to ignite your potential, sharpen your skills, and propel you toward a future where you don’t just succeed—you redefine what’s possible. Art of Client Communication Cornerstone Program Bench Program Tech Bench Program Continuous Education Reimbursement

Requirements

A bachelor’s degree in either the following: Healthcare administration, public health, business administration, social work or related field
Minimum of five years’ complaint resolution experience
Experience with root cause analysis, case tracking, reporting, and regulatory compliance
Experience in complaints, grievances management, appeals, and member services within healthcare, managed care or regulatory environment
Project management skills, knowledge of healthcare, Medicaid programs, and leadership experience
Ability to identify and respond to customer needs and circumstances
Knowledge of contract/client requirements
Ability to handle confidential information in a professional manner
Ability to acquire and maintain in-depth knowledge of department process and procedures
Exemplary communications skills
Strong leadership skills
Ability to maintain high level of confidentiality
Moderate to advanced knowledge of Microsoft applications, including Word, Excel, Access; PowerPoint
Knowledge of Medicaid grievance and appeal processes and relevant federal/state regulations

Nice To Haves

Knowledge of MTM protocols preferred

Responsibilities

Coordinate responses to complaints/grievances to ensure high quality of care for Washington DC beneficiaries, including managing the dedicated telephone line
Build out and maintain the initial notification process for incidents and accidents
Manage the DC Quality Care email box to ensure receipt of grievances/complaints
Manage escalated complaints
Manage and ensure timely compliant resolutions of beneficiary issues
Continuously educate employees on new processes and procedures
Ensure beneficiary concerns are addressed which may require additional solution-based initiatives
Provide operational improvement recommendations to Leadership
Provide hands-on training, as needed
Other duties as assigned