Patient Safety & Resolution Specialist - Risk Management - Full Time 8 Hour Days (Exempt) (Non-Union)

University of Southern California•Los Angeles, CA

3d•$81,120 - $133,010

About The Position

Reporting to the Program Manager, Patient Safety & Resolution, the Patient Safety, Risk & Resolution Specialist supports Keck Medicine of USC's systemwide approach to patient harm response, grievance management, and risk mitigation within the Office of Integrated Risk Management. The Specialist is responsible for the day-to-day management and administration of patient grievances, adverse event investigations, and Communication & Resolution Program (CRP) activities, ensuring timely, accurate, and compassionate responses to patient and family concerns. The role conducts structured investigations, drafts high-quality grievance and CRP communications, and supports claims, insurer reporting, subpoenas, and litigation-related activities in coordination with the Program Manager and Senior Director of Claims and Finance. Essential Duties: Patient Concerns, Grievances & CRP Support Receive, triage, and document patient and family concerns and regulatory grievances. Draft grievance responses and CRP letters aligned with Program Manager standards. Support early communication with patients and families following harm events. Acts as a Communication Lead for CRP cases Assist with preparation for patient/family meetings. Escalate complex or high-risk cases to the Program Manager. Investigations & Case Development Conduct structured investigations into adverse events and grievances. Develop case timeline and create clinical information. Collaborate with key stakeholders including clinical teams and OGC. Claims Administration & Insurance Coordination Prepare and submit First Reports of Claim to BETARMA. Maintain organized claims files and documentation. Track deadlines and support insurer investigations. Litigation Support, Subpoenas & Discovery Process subpoenas and legal record requests. Assemble medical records, statements, and timelines. Coordinate with OGC and outside counsel as directed. Data Management, Reporting & Analysis Enter and manage data in Risk Management Systems (RMS). Support development of reports and dashboards. Analyze trends to identify learning opportunities. Learning, Systems Improvement & Education Contribute to development of toolkits, templates, and workflows. Assist in creating training materials related to grievances and patient safety. Support organizational learning initiatives. Perform other duties as assigned.

Requirements

Bachelor’s Degree Legal, Compliance, Healthcare Administration, Risk Management, or related field.
5 years Experience in healthcare risk management, patient relations, grievance management, quality/safety, or medical litigation/claims.
Conduct structured, objective investigations using interviews, record review, and chronology building.
Analyze complex clinical and legal information and synthesize it into clear, accurate summaries.
Draft high-quality grievance responses, CRP letters, and insurer reports with empathy and precision.
Communicate effectively with patients, families, clinicians, executives, insurers, and counsel.
Manage claims intake, insurer reporting, and documentation with accuracy and timeliness.
Support litigation processes, including subpoenas, discovery coordination, and record assembly.
Interpret and apply regulatory requirements (CMS, state, internal policy) to grievance and claims workflows.
Maintain confidentiality, privilege protection, and defensible documentation standards.
Navigate sensitive, emotionally charged interactions with professionalism and emotional intelligence.
Coordinate across multidisciplinary teams and manage multiple deadlines in a dynamic environment.
Fire Life Safety Training (LA City) Fire and Safety Certification. If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date. (Required within LA City only)

Nice To Haves

Master’s degree in a related field.
Experience in an Academic Medical Center.
Experience in academic medical centers, hospital risk management, or insurance defense law
Knowledge of ASHRM best practices, communication resolution programs, and just culture frameworks
Familiarity with National Practitioner Data Bank (NPDB) reporting, healthcare disclosure laws, and international insurance policies
Certification - Job Relevant LEAN or Six Sigma Certification, Paralegal or Healthcare Risk Management Certification.

Responsibilities

Receive, triage, and document patient and family concerns and regulatory grievances.
Draft grievance responses and CRP letters aligned with Program Manager standards.
Support early communication with patients and families following harm events.
Acts as a Communication Lead for CRP cases
Assist with preparation for patient/family meetings.
Escalate complex or high-risk cases to the Program Manager.
Conduct structured investigations into adverse events and grievances.
Develop case timeline and create clinical information.
Collaborate with key stakeholders including clinical teams and OGC.
Prepare and submit First Reports of Claim to BETARMA.
Maintain organized claims files and documentation.
Track deadlines and support insurer investigations.
Process subpoenas and legal record requests.
Assemble medical records, statements, and timelines.
Coordinate with OGC and outside counsel as directed.
Enter and manage data in Risk Management Systems (RMS).
Support development of reports and dashboards.
Analyze trends to identify learning opportunities.
Contribute to development of toolkits, templates, and workflows.
Assist in creating training materials related to grievances and patient safety.
Support organizational learning initiatives.
Perform other duties as assigned.