SlipstreamJobs tracks this role from the company's public career site. Apply directly on the employer's site.
Salary: USD 28 - 34 / hourly
Akido Labs is an AI-native healthcare provider serving 500K+ patients across California, Rhode Island, and New York, offering primary and specialty care in 26 specialties. Founded in 2015 (YC W15), Akido recently raised a $60M Series B to expand its ScopeAI clinical AI platform.
The Grievance Coordinator serves as the central point of contact for managing, investigating, documenting, and resolving all health plan grievances, complaints, appeals support, and regulatory inquiries across the regional clinic network. This role ensures timely, accurate, and compliant responses in accordance with federal, state, health plan, and organizational requirements.
Key responsibilities include:
- Receiving, reviewing, investigating, and responding to grievances within regulatory and contractual timelines
- Collaborating with clinic leaders, providers, and operational teams to gather investigation information
- Preparing clear, accurate, and professional written responses to health plans regarding member complaints
- Reviewing medical records, documentation, policies, and procedures to support investigations
- Ensuring grievance responses meet health plan, CMS, state, and organizational requirements
- Maintaining detailed records of investigations, findings, corrective actions, and resolutions
- Monitoring grievance deadlines and ensuring timely submission of responses
- Identifying trends and recurring issues through grievance analysis
- Escalating high-risk, regulatory, compliance, or quality concerns to leadership
- Coordinating with Patient Relations, Quality, Compliance, and Clinical Operations teams to implement corrective actions
- Participating in audits and preparing documentation for health plan reviews and regulatory requests
- Maintaining confidentiality and compliance with HIPAA and privacy regulations
- Analyzing grievance trends and identifying opportunities for process improvement
- Preparing recurring reports and dashboards on grievance volume, timeliness, outcomes, and trends
- Providing education and guidance to clinic staff regarding grievance management processes
- Supporting patient experience initiatives by identifying barriers impacting member satisfaction
The ideal candidate possesses strong investigative skills, exceptional written communication abilities, healthcare operations knowledge, and the ability to manage multiple deadlines in a fast-paced environment.
Requirements:
- High School Diploma or equivalent
- Minimum 1 year of healthcare operations, patient relations, grievance management, quality, compliance, or health plan experience
- Experience investigating and responding to patient complaints, grievances, or regulatory inquiries
- Knowledge of managed care, healthcare operations, regulatory compliance, and health plan requirements
- Strong written communication skills with ability to draft professional and detailed correspondence
- Excellent organizational and time management skills
- Ability to manage multiple projects and deadlines simultaneously
- Proficiency with electronic health records (EHR), Microsoft Office Suite, and reporting systems
- Strong analytical, problem-solving, and investigative skills
- Ability to maintain confidentiality and exercise sound judgment when handling sensitive information
Preferred qualifications:
- Experience working with Medicare, Medicaid, Commercial Health Plans, or Delegated Medical Groups
- Prior experience in grievance and appeals management
- Knowledge of CMS, DHCS, NCQA, and health plan grievance requirements
- Experience with quality improvement and performance improvement initiatives
- Experience preparing regulatory responses and corrective action plans
