California Licensed Clinical Grievances Specialist

Job Summary

Responsible for reviewing clinical cases and managing grievances, the full-time California Licensed Clinical Grievances Specialist will conduct concurrent and retrospective medical record reviews, collaborate with clinical teams, and serve as a liaison between patients and the hospital to ensure regulatory compliance and high-quality care.

Key responsibilities:

• Manage complaints and grievances from patients and families, focusing on clinical issues and adhering to regulatory requirements
• Conduct thorough reviews of inpatient and outpatient medical records to assess compliance with care standards
• Collaborate with medical management staff to clarify and resolve clinical grievance cases and improve patient satisfaction

Required qualifications:

• Bachelor's degree in a relevant field from an accredited college or university
• Minimum of 3 years of progressively responsible experience in a related role
• Current Registered Nurse (RN) license
• Strong clinical knowledge and understanding of medical terminology
• Ability to analyze and synthesize information from medical records effectively