Grievance Specialist

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Grievance Specialist based in the United States.

• This fully remote role focuses on resolving member grievances accurately, compassionately, and within required regulatory timelines.
• You will investigate cases, review member records and applicable policies, and identify the underlying causes of concerns.
• The position combines healthcare operations, regulatory compliance, customer service, documentation, and cross-functional collaboration.
• You will communicate directly with members, including individuals who may be frustrated or vulnerable, while working to build trust and provide clear resolutions.
• Your work will also contribute to identifying recurring issues and opportunities to improve processes and the overall member experience.
• Success requires strong attention to detail, sound judgment, organization, and the ability to manage changing priorities and case volumes.
• This is an opportunity to make a meaningful impact in a member-focused healthcare environment while applying your Medicare and grievance-management expertise.