This role leads a dedicated team of escalation/complaint case specialists, accountable for delivering a high-performance, patient-centred complaints resolution. It works closely with cross-functional teams to manage and resolve cases, ensuring compliance with regulatory standards and policies. Key responsibilities include analysing complaint trends to identify systemic improvements, coaching team members to meet and exceed performance metrics, and implementing best practices that enhance the overall patient experience.
Key Responsibilities
People Leadership
- Build and lead a high-performing team by providing clear leadership, direction and support to employees, ensuring they have a clear understanding of their roles and responsibilities.
- Ensure compliance with company policies and processes, taking timely and fair action in instances of unsatisfactory performance or conduct.
- Support and promote a working environment and services that are inclusive, accessible and celebrate diversity.
- Set team OKRs and KPIs in relation to patient/customer satisfaction, NPS, and monitor metrics to identify areas for improvement and optimisation.
Complaint Case Management & Reporting
- Act as a hands-on leader in the complaint resolution process, working closely with the team to ensure patient concerns are managed in an efficient, effective, and empathetic manner.
- Develop and oversee a robust system for tracking and reporting complaint trends and root cause analysis to drive continuous improvement.
- Create and deliver regular operational reports on case management metrics, team performance, and emerging complaint trends, using data to inform decision-making and optimise team and service performance.
Community Guidelines Investigation
- Oversee and support the investigation of breaches of community guidelines, determining when patient behaviour warrants potential service denial, and ensuring actions are documented and compliant with internal policies and external regulations.
- Ensure that all guideline breaches are handled consistently, fairly, and in alignment with organisational standards.
Collaboration & Resolution Framework
- Establish routines with cross-functional teams to support proactive problem-solving, innovative solutions, and efficient resolution of patient concerns.
- Build and continuously refine frameworks for handling patient complaints, ensuring these frameworks are responsive to emerging trends, patient feedback, and regulatory requirements.
- Act as the escalation point for extreme or complex calls, providing hands-on support and leadership to the team to resolve challenging situations.
