Client Grievance Specialist

 

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.

 

Responsibilities

• Investigate and resolve member grievances by reviewing call logs, recordings, documentation, and internal systems
• Maintain accurate and detailed case records within internal systems in compliance with organizational standards
• Apply critical thinking to independently manage complex or escalated cases with minimal supervision
• Collaborate with cross-functional teams to gather, validate, and analyze information necessary for case resolution
• Prepare and deliver clear, well-documented reports and summaries to department managers and leadership
• Submit grievance reports to Health Plan Partners in accordance with contractual and regulatory obligations
• Identify trends and recurring issues, escalating to leadership to support continuous quality improvement initiatives
• Ensure grievance handling complies with CMS and Medicaid/Medicare regulations, meeting all required timelines and standards

Position Requirements  

• High school diploma or GED required
• 2+ years of experience in healthcare administration or a related field at minimum
• Hands-on experience with Salesforce for case management, reporting, or documentation
• Analytical, problem-solving, and critical thinking skills
• Excellent verbal and written communication skills, with the ability to explain complex issues clearly and empathetically
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
• Ability to manage sensitive and confidential information while working independently in a fast-paced environment

Benefits 

• Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
• Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
• Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave
• Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts 

 

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.

Equal Opportunity Employer
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