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.