Complaints Specialist

Title: Complaints Specialist

Location: United States

Department: Team Member

Remote

Full-Time

Job Description:

Who We Are

At Lucet, we’re transforming whole-person care. We deliver integrated behavioral and physical health solutions that connect individuals to the right care at the right time—improving outcomes and overall well-being. Serving over 15 million lives across the U.S. and Puerto Rico, our model combines clinical expertise, compassionate care, and innovative technology to support healthier, more fulfilling lives.

As part of the Lucet team, employees join a mission-driven organization committed to making a lasting impact. Whether through behavioral health navigation, in-home medical care, or 24/7 crisis support, our work is rooted in empathy, collaboration, and a shared passion for helping people thrive.

Why Join our Team

At Lucet, we’re committed to creating a workplace where top talent thrives both personally and professionally. We offer a dynamic, mission-driven environment where your work has real impact, your unique background and experience are valued, and no two days are alike. If you’re passionate about meaningful work and delivering impactful results, we encourage you to apply!

We support our team with a competitive compensation and benefits package, including:

• Annual compensation between $65,000 - $85,000, PLUS an annual performance-based, discretionary incentive.
  • *Compensation is dependent on non-discriminatory factors including but not limited to an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.
• Comprehensive health benefit options: Medical, dental, and vision coverage
• 401(k) with competitive employer match
• Company-paid life and disability insurance
• Paid parental leave and wellbeing incentives
• Generous paid time off, including volunteer time
• Flexible spending accounts for healthcare and dependent care
• Professional development opportunities and tuition reimbursement
• Remote work flexibility (role-dependent)
• Opportunity for meaningful growth, both personally and professionally, where your unique background and experience is welcomed and valued.

At Lucet, your work will directly support our mission to improve behavioral, physical, and social health—one member at a time.

What You Will Do - Essential Functions

The Spec, Complaints is processes quality-of-care complaints, grievances, and incidents. Duties include all aspects of clinical quality of care complaint and incident investigations including documentation, interviews, obtaining responses from providers or facilities, reviewing medical records, staffing findings with the medical director, and resolution processes. This position requires knowledge of standards of care, identification of trends and include audit activity of medical records. The CQS is responsible for clearly written reports, and monitoring compliance.

• Complaint & Incident Management
  • Process, document, investigate, and resolve complaints, grievances, and incidents professionally, confidentially, collaboratively, and in a timely manner.
  • Review patient medical records and apply clinical/regulatory expertise; communicate detailed quality-of-care findings to management as appropriate.

• Data, Reporting & Analytics

  • Collect and analyze data for complaint/incident reports, audits, and improvement teams; apply statistical analyses as appropriate.
  • Prepare and present reports for internal meetings, external auditors/providers, senior executives, the Board, and external customers/employers.

• Accreditation & Performance Improvement

  • Support accreditation readiness: develop deliverables, coordinate cross‑departmental projects, and facilitate adherence to accreditation standards.
  • Lead/participate in regional performance improvement initiatives using PI methodologies and basic tools; manage assigned projects from design through presentation and implementation of improvements.

Who You Are

Required Qualifications

• • Unencumbered license to practice independently in a behavioral health related field or a BSN/RN
  • 3+ years post licensure behavioral health with facility-based and/or outpatient behavioral health or chemical dependency treatment OR healthcare experience with in-home primary or longitudinal care.
  • 1+ year of experience working with quality management principles, study design, data analysis, and report preparation
  • 1+ years of experience in medical record review, interpreting medical or behavioral cases with a cognitive understanding of evidence- based standards and medical practice.
  • Intermediate skills with Microsoft Office (Word, Excel, Power Point and Outlook) and Visio
  • Ability to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.

Living our Values:

• • Serving everyone with compassion and leading with empathy.
  • Stepping up and creating value by taking charge and acting when there is an opportunity.
  • Adapting in a changing world by recognizing our responsibility to be agile and respond quickly.
  • Nurturing growth and belonging by respecting and celebrating everyone for who they are.

 Competencies

• • Critical thinking and analytical skills; able to decipher best practice research with statistical discrimination, design audits and surveys.
  • Strong written communication skills including routine ability to compose correspondence, memos, and reports, with text tables and graphics as required.
  • Flexibility and ability to multi-task
  • Highly organized and detail-oriented
  • Adaptable to various software programs
  • Actively participate in and positively contribute to team processes and lead team activities
  • Problem Solving

• Working Conditions:
  • Work is performed from home with company-provided equipment. Sitting for long periods of time is expected and use of fingers and hands for typing is necessary.
  • A quiet workspace with minimal background noise for calls.
  • High-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds (must be installed before starting) required.
  • Frequent use of computer and phone systems
  • Must be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.

• We encourage applicants from a variety of backgrounds and experiences to apply, especially those who can demonstrate how their unique qualifications and skills align with the requirements of this role and support our mission to improve whole-person health.