Sr Manager Patient Complaints & Grievances

Catholic Health•Melville, NY

6h•Onsite

About The Position

The Senior Manager, Patient Complaints & Grievances provides system-level strategic direction, governance support, and oversight for the organization's patient/family complaint and grievance program. This role does not manage day-to-day case intake or resolution — that work remains with local site/facility resources. Instead, this leader is responsible for standardizing the process across the system, ensuring regulatory compliance in close partnership with the Quality and Compliance teams, equipping local teams with the tools and training to resolve cases effectively, and driving data-informed initiatives that reduce the volume and severity of complaints and grievances system-wide. This role reports into Patient Experience and works in strong, ongoing alignment with Quality and Compliance to ensure regulatory requirements, risk considerations, and quality outcomes are fully integrated into the complaint and grievance program.

Requirements

Bachelor's degree required (Nursing, Healthcare Administration, Public Health, or related field).
5+ years of progressive healthcare experience, including direct experience with patient relations, complaint/grievance management, quality, risk management, or patient experience.
2+ years supporting multi-site, system-level, or cross-functional initiatives preferred.
Working knowledge of CMS Conditions of Participation and accreditation standards related to grievances.
Experience contributing to or leading process improvement initiatives across multiple sites or a matrixed organization.
Working knowledge of healthcare regulatory requirements governing grievances and complaints.
Strong data analysis and dashboard/reporting skills; comfort with EHR/complaint tracking systems (e.g., RL Datix, Midas, custom CRM tools).
Ability to influence without direct authority across a decentralized, multi-site structure.
Strong written and verbal communication skills, including presenting to Patient Experience, Quality, and Compliance leadership.
Process design and change management skills.
Skilled facilitator able to build consensus among diverse stakeholders (clinical, operational, legal/risk).

Nice To Haves

Master's degree preferred (MHA, MBA, MSN, or related).
RN licensure (if clinical background)
Certified Professional in Patient Experience (CPXP)
Lean/Six Sigma certification
Certified Professional in Healthcare Quality (CPHQ)

Responsibilities

Develop and maintain a system-wide strategy for complaint and grievance management, aligned with Patient Experience, Quality, and Compliance priorities.
Design a standardized, scalable operating model (intake, triage, escalation, response, closure) that local sites can execute consistently.
Identify and prioritize initiatives aimed at reducing root causes of complaints and grievances (e.g., communication breakdowns, wait times, billing issues, care coordination gaps).
Partner closely with Quality and Compliance to ensure the program meets CMS Conditions of Participation, state regulations, and accreditation standards (e.g., Joint Commission, DNV) for grievance handling and response timelines.
Support and help facilitate a system-wide governance forum to review policy, escalation pathways, and performance against regulatory timelines.
Maintain system-wide policies and procedures; monitor local sites' compliance with regulatory and internal standards.
Serve as a key contact supporting audit readiness and regulatory surveys related to grievance processes, in coordination with Compliance.
Partner with local complaint/grievance resources (site-based coordinators, patient relations staff, nurse managers, etc.) to implement system strategy without displacing their day-to-day ownership of cases.
Develop tools, templates, training curricula, and job aids that enable consistent, high-quality local execution.
Build a community of practice among local resources for peer learning, escalation support, and shared problem-solving.
Monitor local performance against defined KPIs and provide coaching, resources, or process adjustments where sites need support.
Establish system-wide metrics and dashboards (volume, category/type, time-to-resolution, regulatory timeliness, recurrence rates, satisfaction with resolution).
Conduct trend and root-cause analysis to identify systemic drivers of complaints and grievances.
Deliver regular reporting to Patient Experience, Quality, and Compliance leadership.
Use data to prioritize and measure the impact of reduction initiatives.
Lead cross-functional improvement projects (with Nursing, Physician Leadership, Revenue Cycle, Environmental Services, Food & Nutrition, etc.) targeting top complaint drivers.
Apply quality improvement methodologies (e.g., Lean, Six Sigma, PDSA) to redesign processes contributing to recurring issues.
Partner with Patient Experience/HCAHPS teams to align grievance-reduction work with broader experience improvement strategy.
Champion a proactive service recovery culture across the system.
Build strong relationships with facility/site leadership to ensure buy-in and accountability for the program without owning their operational workload.
Represent the complaints/grievances function in Patient Experience, Quality, and Compliance forums.
Educate leadership at all levels on trends, risks, and shared responsibility for a positive complaint/grievance culture.
Mentor and support (though not directly manage) local complaint/grievance staff on best practices.