Grievance and Appeals Specialist

Requirements: Bachelor s degree in Business Administration, Nursing, Social Work, or a healthcare-related field, or equivalent education and experience. 2 years of recent relevant experience in patient relations, patient experience, grievances, appeals, or case management.

Job Title: Experience of Care Specialist /Grievance and Appeals specialist
Location: Onsite at Roseville .3 days per week and Auburn 2 days per week
Schedule: | Day, Full Time, Non-Exempt 8/80 | Approximately 5 6 months | Two-campus assignment, no direct patient care

Requirements:

• Bachelor s degree in Business Administration, Nursing, Social Work, or a healthcare-related field, or equivalent education and experience
• 2 years of recent relevant experience in patient relations, patient experience, grievances, appeals, or case management
• Experience with investigating patient and family complaints, grievances, and quality-of-care concerns
• Experience with medical record, policy, procedure, and case documentation review
• Ability to manage a high caseload and meet CMS, CDPH, and organizational response timelines
• Strong written communication skills, including synthesizing investigation findings into compassionate responses
• Proficiency in conflict resolution, mediation, problem-solving, and service recovery
• Ability to collaborate with hospital leaders, physicians, clinical staff, and administrative departments
• Proficiency in word processing, email, calendars, databases, and department-specific software
• Ability to work independently across both assigned hospital campuses

Preferred Requirements:

Experience with crisis intervention involving difficult or volatile patient situations
Experience collaborating with Legal and Risk Management on complex medical-legal matters
Experience developing action plans related to complaint investigations and quality improvement
Experience supporting patient rounding and leadership follow-up
Experience working in a fast-paced, multi-facility hospital environment
Demonstrated cultural competence and sensitivity to diverse patient populations