Grievance Coordinator

📋 Description

• Serve as the primary coordinator for all health plan grievances, complaints, and member concerns
• Receive, review, investigate, and respond to grievances within required regulatory and contractual
• Collaborate with clinic leaders, providers, departments, and operational teams to gather
• Prepare clear, accurate, and professional written responses to health plans regarding member
• Review medical records, documentation, policies, procedures, and operational processes to support
• Ensure grievance responses meet health plan, CMS, state, delegated entity, and organizational

🎯 Requirements

• High School Diploma or equivalent required.
• Minimum of one (1) year of healthcare operations, patient relations, grievance management, quality
• Experience investigating and responding to patient complaints, grievances, or regulatory inquiries.
• Knowledge of managed care, healthcare operations, regulatory compliance, and health plan
• Strong written communication skills with the ability to draft professional and detailed
• Excellent organizational and time management skills.