I admit I like the idea of the film grain and I think it's kind of stylish, but I can't play the game with it and I never have. I just like to have clear view and crisp visuals, I guess.
As for the shadows, MEUITM offers some engine tweaks on its description page and also better shaders on its download page. I'm not sure if they come with the automatic installation (probably) since I install MEUITM manually. But I know that you can Delete Local Shader Cache through ME config and replace them manually by files MEUITM's download page provides (Soft Shadows stand alone). I don't remember having issues with shadows with this set-up.
Otherwise, I force some anti-aliasing and anisotropic filtering. I also use SweetFx to improve the colours and tonemap, to make the game a little bit more colourful and less misty-looking.