Complaint & Grievance Process Administrator – Operations & Policy Analyst 3

Oregon Department of Human Services

Complaint & Grievance Process Administrator overseeing Medicaid complaint processes at Oregon Health Authority. Leading compliance monitoring, trend analysis, and quality improvement initiatives for OHP members and providers.

Posted 6/18/2026full-timeSalem • Oregon • 🇺🇸 United StatesMid-LevelSeniorWebsite

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Hard Skills

data analysisprogram evaluationquality assurancecompliance monitoringperformance improvementproject managementpolicy analysisgrievance processescomplaint managementhealth services delivery

Soft Skills

collaborationcommunicationrelationship buildingtrainingguidanceanalytical thinkingproblem solvingcultural responsivenessleadershiporganizational skills

Industry Keywords

MedicaidOregon Health PlanCoordinated Care Organizationshealthcare providersfederal regulationsstate regulationsconsumer protectionsequitable service deliverysocial justicepublic sector systems

About the role

Key responsibilities & impact

Oversee the Medicaid Division’s complaint process for OHP members and providers.
Lead efforts to monitor compliance with federal and state requirements.
Identify and analyze complaint trends, and support quality improvement initiatives that strengthen accountability and member experience.
Ensure alignment of complaint processes across OHA and ODHS programs.
Provide training, guidance, and technical assistance to internal and external partners.
Represent the division by communicating policy, program, and regulatory information to legislators, state and federal partners, community organizations, and other partners.
Collaborate with diverse populations most harmed by social injustice and inequities.

Requirements

What you’ll need

A Bachelor's Degree in Business or Public Administration, Behavioral or Social Sciences, Finance, Political Science or any degree demonstrating the capacity for the knowledge and skills.
Four years professional-level evaluative, analytical and planning work.
Any combination of experience and education equivalent to seven years of experience that typically supports the knowledge and skills for the classification.
Experience supporting the development, implementation, oversight, or evaluation of complaint, grievance, appeals, quality assurance, or compliance-related programs that improve access, accountability, and equitable service delivery within healthcare or public sector systems.
Knowledge of health services delivery systems, particularly the Oregon Health Plan (OHP), Medicaid administration, Coordinated Care Organizations (CCOs), health plans, healthcare providers, or other complex health and human services systems.
Knowledge of federal and state laws, regulations, and compliance requirements related to Medicaid, grievance and appeals processes, quality assurance, or consumer protections; experience analyzing and applying regulatory requirements to operational practices.
Experience evaluating and synthesizing quantitative and qualitative data to identify trends, assess program performance, monitor outcomes, and support policy, operational, or quality improvement decisions.
Experience leading or supporting continuous quality improvement, performance improvement, or process improvement initiatives, including the development of performance measures, metrics, corrective actions, and outcome monitoring.
Ability to foster collaboration and build effective working relationships across agencies, health plans, providers, advocacy organizations, community partners, and individuals with lived experience to improve programs, services, and outcomes.
Strong oral and written communication skills across a variety of forums; experience communicating complex information, technical requirements, and data findings in ways that are accessible, culturally responsive, and appropriate for diverse audiences.
Demonstrated project management experience, including the ability to manage multiple priorities, coordinate complex initiatives, meet regulatory timelines, and support successful implementation of operational or policy changes.

Benefits

Comp & perks

Excellent, low-cost medical, vision, and dental coverage for you and your family.
Optional benefits like life insurance, disability coverage, deferred compensation, and FSA options for health and childcare.
Generous paid time off: 11 holidays, 3 personal days, monthly sick leave, and vacation accrual starting at 8 hours/month.
Potential eligibility for the Public Service Loan Forgiveness Program.
Retirement security through Public Employees Retirement System (PERS)/ Oregon Public Service Retirement Plan (OPSRP).
Training and development opportunities to grow your career with the State of Oregon.