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

The Patient Safety & Resolution Specialist plays a key role in responding to patient concerns, adverse events, and care-quality issues across Keck Medicine of USC. Reporting to the Senior Director of Claims and Finance within the Office of Integrated Risk Management, the Specialist conducts thorough and impartial investigations; facilitates clear, empathetic communication with patients and families; and manages cases through the complete grievance-to-resolution lifecycle, including early communication under the Communication & Resolution Program (CRP). The Specialist also provides critical operational support for insurer reporting, claims intake, subpoenas, legal record requests, and discovery coordination. This role synthesizes complex clinical and legal information into clear, accurate, and compassionate written and verbal communication. Partnering closely with clinicians, leadership, the Office of General Counsel, outside counsel, and the organization's malpractice insurer, the Specialist helps ensure transparent responses to adverse events, compliance with regulatory and legal requirements, and a systemwide commitment to learning, patient safety, fairness, and trust.

Essential Duties:

• Patient Concerns, Investigations & CRP • Receive and triage patient/family concerns and regulatory grievances. • Conduct structured interviews, gather statements, and synthesize relevant medical record information. • Draft high-quality grievance responses reflecting CRP principles—empathy, clarity, transparency, and accountability. • Support early communication with patients/families following harm events; draft CRP letters; coordinate preparation and logistics for family meetings. • Provide guidance, emotional support, and resources to clinicians involved in adverse events.
• Claims Administration & Insurance Coordination • Prepare and submit First Reports of Claim to BETARMA and maintain complete, organized claim files. • Maintain timelines, correspondence, and documentation required for insurer processes. • Support insurer investigations, early-resolution discussions, and compliance with policy and reporting requirements. • Track deadlines, exposures, and data needed for internal reporting and insurer updates.
• Litigation Support, Subpoenas & Discovery • Process subpoenas, legal inquiries, and medical-record requests in accordance with policy, confidentiality standards, and privilege rules. • Coordinate discovery responses with the Office of General Counsel (OGC), outside counsel, and clinical departments. • Assemble medical records, statements, timelines, and other materials needed for litigation matters. • Monitor litigation milestones, hearings, depositions, filings, and related deadlines.
• Learning, Systems Improvement & Professional Standards • Identify system issues, trends, and improvement opportunities arising from grievances, CRP cases, claims, and litigation. • Contribute to development of toolkits, templates, training materials, workflows, and policy updates. • Maintain high standards of courtesy, neutrality, confidentiality, and defensibility in all communication and documentation. • Support learning across the organization and contribute to advancement of risk-management practice through analysis, documentation, and shared insights.
• Perform other duties as assigned.

Required Qualifications:

• Req Bachelor’s Degree Legal, Compliance and Related Fields

• Req 5-10 years Experience in healthcare risk management, patient relations/ experience, grievance management, medical litigation, insurance law, or claims administration

• Req Conduct structured, objective investigations using interviews, record review, and chronology building.
• Req Analyze complex clinical and legal information and synthesize it into clear, accurate summaries.
• Req Draft high-quality grievance responses, CRP letters, and insurer reports with empathy and precision.
• Req Communicate effectively with patients, families, clinicians, executives, insurers, and counsel.
• Req Manage claims intake, insurer reporting, and documentation with accuracy and timeliness.
• Req Support litigation processes, including subpoenas, discovery coordination, and record assembly.
• Req Interpret and apply regulatory requirements (CMS, state, internal policy) to grievance and claims workflows.
• Req Maintain confidentiality, privilege protection, and defensible documentation standards.
• Req Navigate sensitive, emotionally charged interactions with professionalism and emotional intelligence.
• Req Coordinate across multidisciplinary teams and manage multiple deadlines in a dynamic environment.

Preferred Qualifications:

• Pref Master’s degree Degree in a related field.
• Pref Experience in academic medical cen