Client Grievance Specialist

Job Description

Job Description

Position : Client Grievance Specialist

We are looking for a detail-oriented and compassionate Client Grievance Specialist to join our team. The ideal candidate will be responsible for managing, investigating, and resolving patient complaints and grievances in compliance with CMS standards and health plan contractual obligations. This role is essential in ensuring patient satisfaction, compliance, and continuous quality improvement.

Roles and Responsibilities

• Acknowledge, examine, and investigate patient complaints by reviewing call logs / recordings while leveraging internal systems for research
• Maintain accurate records and documentation within internal systems
• Use critical thinking to independently manage complex or escalated cases with minimal supervision
• Collaborate with internal teams to collect all necessary information
• Prepare and submit summary reports and findings regarding grievances to the relevant department managers
• Report to Health Plan Partners as per contractual obligations
• Identify trends or recurring issues and escalate them to leadership for quality improvement initiatives
• Manage grievances in accordance with Centers for Medicare and Medicaid (CMS) standards, ensuring timely resolution and responses that comply with applicable regulations and internal guidelines.

Position Requirements

Benefits

About Monogram Health

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. .