Job Title: Grievances & Appeals Specialist Location: Onsite in San Francisco, CA (ZIP: 94109) Contract Type: W2 Contract-to-Hire Pay Rate: $38/hour + Full Benefits Schedule: Monday–Friday, 8:00 AM – 5:00 PM We’re hiring a Grievances & Appeals Specialist to support a leading healthcare provider in San Francisco. This full-time, onsite, contract-to-hire opportunity offers a competitive pay rate and full benefits. In this role, you’ll investigate and resolve patient and family complaints regarding care quality, provider actions, and organizational policies. You’ll manage highly complex and sensitive cases, working closely with physicians, department leaders, Legal, and Risk teams to resolve grievances in a timely, compliant, and compassionate manner. Key Responsibilities: Investigate complaints related to care delivery, staff conduct, and internal policies. Conduct interviews, review medical records, and analyze procedures to assess cases. Coordinate with leadership to implement corrective actions and quality improvements. Work with Legal/Risk on potential liability and compliance concerns. Provide crisis support and mediation during sensitive case resolution. Ensure all documentation and timelines align with CMS and organizational standards. Required Qualifications: Bachelor’s degree in Nursing, Business, Social Work, or related field — or equivalent experience. 2+ years of recent experience in grievances, appeals, or patient advocacy. strong communication and conflict resolution skills. Familiarity with federal regulations, including CMS Conditions of Participation. Proficiency with Microsoft Office and healthcare documentation systems. Ability to manage a high-volume caseload independently and with urgency. This is a high-impact role for someone who is passionate about improving the patient experience and ensuring accountability and transparency in healthcare. Apply now to be considered for this meaningful opportunity!salary: $38.39 - $38.4 per hourshift: Firstwork hours: 8 AM - 5 PMeducation: High SchoolResponsibilitiesInvestigating 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.SkillsQuality AssuranceQuality ControlBenefits AdministrationQualificationsYears of experience: 2 yearsExperience level: ExperiencedRandstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).This posting is open for thirty (30) days. Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance. Qualified applicants in the unincorporated areas of Los Angeles County with criminal histories will be considered for employment in accordance with the Los Angeles County's Fair Chance Ordinance for Employers. We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.