What are the responsibilities and job description for the Quality Assurance Analyst position at TechOneIT?
Job Overview
The Grievances & Appeals Specialist plays a critical role in supporting patients and families by investigating complaints, concerns, and feedback received by the organization.
Responsibilities
- Investigating patient/family complaints related to care quality, physician/provider actions, Sutter Health policies, and potential liability.
- Handling highly complex and conflict-heavy cases, requiring innovation and collaboration across departments.
- Working closely with managers, physicians, and staff to resolve patient grievances.
- Coordinating with Legal and Risk Management on medical-legal matters.
- Providing crisis intervention and mediation for complex institutional concerns.
- Conducting case investigations, including interviews with patients/families, medical record reviews, and policy/procedure evaluations.
- Facilitating case conferences and working with leadership to implement corrective action plans for quality improvement.
- Ensuring compliance with CMS Conditions of Participation and Sutter Health grievance policies.
- Maintaining a patient and family-centered approach, prioritizing transparency and resolution at the most appropriate levels.
- Managing a high caseload and ensuring timely documentation to meet regulatory timelines.
Job Type: Contract
Pay: $30.00 - $36.00 per hour
Expected hours: 40 per week
Schedule:
- 8 hour shift
- Monday to Friday
- Weekends as needed
Experience:
- grievances: 5 years (Required)
- Appeals: 4 years (Required)
- records: 4 years (Required)
- Investigation: 4 years (Required)
Ability to Commute:
- San Francisco, CA 94109 (Preferred)
Ability to Relocate:
- San Francisco, CA 94109: Relocate before starting work (Required)
Work Location: In person
Salary : $30 - $36
