Psychiatric Complaints and Grievances Specialist

🕒 5 days ago

🇺🇸 United States – Remote

💵 $128k - $149.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Rula

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2019

💼 Consulting

🛡️ Insurance

🏥 Healthcare

💰 Series C - Rula on 2024-07

Consulting • Insurance • Healthcare

Rula is a mental health care platform that connects patients with licensed therapists and psychiatric providers across the United States, offering online and in-person therapy, psychiatry, and medication management. The platform works with over 120 insurance plans nationwide (including Medicare, Medicaid, and many major commercial carriers), verifies coverage, provides cost estimates, and offers in-network pricing (average $15 per session with insurance) and cash rates for self-pay. Rula supports 90+ conditions (anxiety, depression, PTSD, ADHD, OCD, bipolar disorder, etc. ), provides tools for scheduling and managing appointments, and offers resources like tests/quizzes and a provider directory spanning all 50 states. It serves patients directly and partners with employers, health plans, and health systems, and emphasizes clinical standards, provider reviews, and ongoing professional development.

📋 Description

• Own the clinical review and resolution of psychiatric complaints and grievances • Investigate cases through chart review and provider outreach • Render clear and fair determinations about quality, safety, or appropriateness of care • Resolve and document each case within expected SLAs • Identify recurring patterns and surface them to Psych Quality leadership • Collaborate with Psych Clinical Quality NPs, Psychiatric Patient Programs NP, and non-clinical Psych support teams • Maintain a small direct patient-care panel comprising approximately 30% of working time • Build the patient-care panel after gaining command of the complaints-and-grievances pathway • Practice using the same platform, workflows, and documentation standards as reviewed providers • Provide direct and empathic feedback to peer clinicians • Report as an individual contributor to the Associate National Medical Director • Contribute to improving quality of care across Rula's psychiatric network

🎯 Requirements

• Active, unrestricted PMHNP license • Minimum of 3 years of outpatient psychiatric practice • Valid CA DEA registration • Current Board Certification as a PMHNP (ANCC or AANP) • 3+ years of experience providing comprehensive psychiatric care in a fully remote telehealth setting • Familiarity with clinical and safety considerations of remote practice • 1+ years of experience in a dedicated quality improvement, chart audit, or peer coaching role • Experience delivering feedback or education to psychiatric providers, particularly in a 1099 or non-traditional employment model • Strong written and verbal communication skills • Ability to deliver empathic, direct, and succinct feedback to peer clinicians • Ability to hold clinical or safety standards under pressure • Proficiency with modern EHR and clinical workflow platforms • Comfort learning new systems quickly • Strong technical aptitude and adaptability • Preferred: Active CPHQ certification • Preferred: Experience using AI or AI-augmented tools in clinical workflows • Preferred: Active PMHNP licensure in multiple states, with preference for Florida, Tennessee, Georgia, and/or New York • Preferred: Experience contributing to clinical L&D content

🏖️ Benefits

• 100% remote work environment • Attractive pay and benefits • Medical, dental, vision, life, disability, and FSA/HSA • 401(k) plan access • 2 company-wide shutdown weeks each year for self-care (for most employees) • Paid parental leave for birthing, non-birthing, adopting, and fostering parents • Employee Assistance Program (EAP) • Quarterly department stipend for team-building activities or in-person gatherings • Community and employee resource groups • New hire home office stipend • $50 monthly stipend for internet or cell phone expenses • Year-round wellness initiatives • $50/month wellness stipend • No bonus for this role