Risevoic
Appeals and Grievances Coordinator
Company : Catholic Health Initiatives
Location : Rancho Cordova, CA, 95670-7956
Job Type : Full Time
Salary : 24-32.74 HOUR
Date Posted : 11 January 2026
Job Summary and Responsibilities
***This position is hybrid in-office and work from home.
Position Summary:
The Appeals and Grievances Coordinator is responsible for supporting the appeals department team members by managing and coordinating the appeals and grievance process. This role involves:
- facilitating delivery of member and provider complaints
- ensuring compliance with regulatory requirements
- facilitating timely and effective resolution of appeals and grievances.
Acting a subject matter expert (SME), the Coordinator will work closely with internal teams and external stakeholders to ensure a high level of service and satisfaction.
This position oversees a mix of operational, business and regulatory activities related to several Health Plan Partnerships. This position will work closely with health plan partners to ensure a seamless transition in implementing new and ongoing regulatory requirements. From a business perspective, this role is responsible for the ongoing delegation and performance of our contractual obligations with our Health Plan partners.
Job Requirements
Minimum Qualifications:
- 2+ years administrative experience in a compliance auditing arena. Previous experience in a similar administrative or coordination role.
- Associates degree or 3 years of related job or industry experience in lieu of degree
- Familiarity with healthcare regulations, including HIPAA, CMS, and state-specific requirements
Preferred Qualifications:
- 2 years managed care experience preferred
- 1 year delegation oversight experience preferred
- Regulatory audit experience preferred
- Bachelors degree or 5 years of related job or industry experience in lieu of degree preferred
- Certified Compliance Professional (CCP) Certified Professional in Healthcare Quality (CPQH) Certified Healthcare Auditor (CHA) preferred
- Knowledge of DMHC, NCQA, CMS and other regulatory bodies preferred
- Knowledge of HIPPA, managed care environment preferred
- Strong technical proficiency in data analysis; database software preferred
- Familiarity with compliance requirements is a plus
Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health – one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. Our 130+ clinics across the state of California deliver high-quality, patient-centric care with an emphasis on humankindness. Through affiliations with Dignity Health hospitals, along with our joint ventures and partnerships, we offer a robust, state-of-the-art health care delivery system in the communities we serve .We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.
One Community. One Mission. One California
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Frequently asked questions
In Rancho Cordova, an Appeals And Grievances Coordinator must navigate complex state-specific rules like DMHC and HIPAA. This involves coordinating appeals while ensuring strict adherence to both federal and California standards, which is crucial for maintaining regulatory compliance within health plan partnerships.
Beyond typical administrative abilities, a standout coordinator excels in regulatory knowledge, especially CMS and managed care environments. Proficiency in data analysis and experience with delegation oversight deepen their capability to resolve grievances effectively and maintain contractual obligations.
Certifications like Certified Compliance Professional (CCP), Certified Professional in Healthcare Quality (CPHQ), and Certified Healthcare Auditor (CHA) are highly regarded. They demonstrate expertise in compliance and healthcare quality, enhancing a candidate’s appeal in California’s regulated managed care market.
Day-to-day tasks include managing member and provider complaints, collaborating with internal teams and external health plan partners, and ensuring appeals are resolved timely. The role demands balancing operational duties with regulatory oversight to support a seamless grievance process.
Rancho Cordova’s healthcare sector shows moderate competition for roles like grievance and appeals coordinators due to the region’s growing health systems. Candidates with specialized regulatory knowledge and managed care experience tend to have an edge in this evolving market.
Catholic Health Initiatives offers a hybrid work model blending in-office presence with remote flexibility. The organization fosters a mission-driven culture emphasizing humankindness and continuous learning, ideal for coordinators seeking meaningful healthcare roles with supportive teams.
This role actively partners with health plans to oversee delegation tasks, implement regulatory updates, and ensure contractual compliance. Such collaboration is essential for maintaining service quality and satisfying both internal standards and external regulatory bodies.
Salary typically ranges from $60,000 to $80,000 annually, reflecting the specialized nature of this healthcare coordination role and California’s cost of living. Experience in managed care and relevant certifications can push compensation toward the higher end.
Local regulatory demands require coordinators to maintain deep familiarity with state-specific agencies like DMHC alongside federal bodies. This environment pushes for meticulous documentation, proactive grievance handling, and constant regulatory updates to safeguard patient rights.
With experience, coordinators can progress to senior compliance roles, regulatory affairs management, or healthcare quality leadership. The role’s exposure to cross-functional teams and regulatory frameworks provides a solid foundation for upward mobility in healthcare administration.