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Guardian Life Complaints & Grievances Coordinator (Remote) in Helena, Montana

Position Summary

Under minimal guidance, drive continuous improvement and support the objectives of the Quality Management Department. Responsible for assistance in regulatory requirements as defined in the Quality Management Programs for all DHMO States and ensuring compliance. They will continuously strive to provide superior product and customer service and proactively look at new and different ways of approaching work and share ideas and perspectives about increasing effectiveness and efficiency.

Your Responsibilities

Grievances/Provider Disputes – 65%

•Investigate and resolve complaints/grievances/appeals/provider disputes within specific State mandated time frames. Investigate and resolve complaints/grievances/appeals/provider disputes within specific State mandated time frames.

•Verify appropriate policy documents, plan schedules, exclusions & limitations and CDT language are leveraged in the resolution letter as necessary.

•Ensure resolution letters are written in a clear and concise manner with an appropriate level of risk management and include any necessary state mandated enclosures.

•Confirm that all applicable documents used during review are uploaded into FileNet and kept organized and readily accessible in FileNet.

System Documentation 25%

•This position is required to identify and document accurate data in the QMP database and ensure the members’ concerns are appropriately addressed and resolved. All documents relating to the investigation and resolution of a Complaint/Grievance and Appeal/Dispute are to properly uploaded and labeled in FileNet in a timely manner.

Various/Special Projects 10%

•Complete projects as assigned by the Complaints and Grievances Manager and/or Team Leader within agreed upon time frames.

•Assist with projects that drive continuous improvement and support the objectives of the Quality Management Program.

You Have

Functional Skills

•Strong knowledge Guardian Complaints & Grievances processes, systems, state regulation and timeframes

•Ability to work effectively with associates from across the Group Profit Center and with Corporate

•Ability to manage multiple projects with multiple deliverables simultaneously

•Able to adapt to changing business priorities and environments

Leadership Behaviors

•Continuously strives to provide superior products and customer service

•Expresses oneself in an open and honest manner

•Demonstrates self-awareness and embraces feedback

Position Qualifications

•Minimum of 5 years of Guardian specific Quality Management experience

•Certification in Project Management preferred

•Strong Microsoft Word, Excel, PowerPoint skills

Reporting Relationships

This position reports to Guardian’s Team Leader, Complaints & Grievances, who in turn reports to Manager, Complaints & Grievances.

Travel

•Occasional Travel: 0-33% as needed.

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Salary Range

$38,600.00 - $64,330.00

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Inspire Well-Being

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues.

Health Care

  • Choice of [high deductible/copay] medical plans* with prescription drugs, including coverage for fertility and transgender inclusive benefits

  • Dental plan

  • Vision plan

  • Health care accounts – flexible spending, health reimbursement, and health savings accounts

  • Critical illness insurance

Life and Disability Insurance

  • Company-paid Life and Disability insurance plus voluntary supplemental coverage

  • Accident insurance

Retirement and Financial

  • 401(k) retirement plan with a company match, plus an annual age/service-based Company contribution and an annual profit-sharing contribution, if applicable

  • Complimentary 1:1 financial guidance with a licensed Fidelity representative

Time Off and Remote Work

  • Flexible work arrangements (part in-person/part remote)

  • Unlimited paid time off for most roles plus time off for volunteering, jury duty, voting, and bereavement

  • Personal holidays for colleagues to use in recognition of religious, cultural, or civic days

  • Paid parental leave and paid family and medical leave policies

Emotional Well-being and Work-Life

  • Emotional well-being, mental health, and work/life resources powered by Spring Health

  • Wellness programs, including fitness program and equipment reimbursement

  • Child, adult, and elder back-up care support through Bright Horizons

  • Adoption assistance

  • College planning

  • Tuition reimbursement

  • Student loan assistance

  • Commuter benefits in select metropolitan areas

Justice, Equity, Diversity & Inclusion (J.E.D.I.)

  • Employee Resource Groups that advocate for inclusion and diversity

  • J.E.D.I. certification and training programs

  • Matching gifts/volunteering

Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact applicant_accommodation@glic.com .

Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being — mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about Guardian at guardianlife.com .

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