Job Description

Default Work Shift:

Day (United States of America)

Hours:

40

Salary range:

$33.73 - $51.24

Schedule

Full Time

Shift Hours:

8 Hour employee

Department:

Quality Improvement

Job Objective:

Supports the mission to continuously improve the quality and cost effectiveness of care by listening to patients, advocating patient’s concerns, facilitating change to meet the needs of our patients and proactively problem solves to meet patient needs and expectations on an ongoing basis. Acts as liaison between patients and the organization’s administration, staff and physicians. Directs, monitors and coordinates the patient complaint management program, and intervenes to provide Risk Prevention as necessary. Supports Customer Service and Patient Satisfaction.

Job Description:

Education: Required: High school diploma, GED or higher level degree Preferred: Bachelor's degree Licensure/Certification: N/A Experience: Required: Five (5) years of experience in customer service in a healthcare setting

Reports To: Senior Director-Organizational Transformation Supervises: N/A Ages of Patients: Pediatric, Adolescent, Adult, Geriatric Blood Borne Pathogens: Minimal/ No Potential

Skills, Knowledge, Abilities:

Ability to collect, analyze and disseminate data, Ability to effectively communicate in a positive and professional manner, Ability to handle difficult and stressful situations in a calm and professional manner, Ability to make informed decisions under pressure, prioritizing actions to address urgent matters effectively, Ability to organize information or data to facilitate easy retrieval and use, Ability to use Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) and other relevant software applications, Ability to work independently as and as a team member, Knowledge of regulatory and accreditation requirements and standards as they relate to regulatory compliance with TJC, CMS/CDPH and other regulatory agencies, Written and verbal communication skills

Essential Responsibilities

1. Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations. 2. Coordinates, investigates and resolves consumer grievances concerning the quality of care and services and ADA complaints by providing a formal grievance mechanism for the organization; acts as a liaison between patients, their families, community, physicians, and hospital staff; monitors grievances; navigates institutional “red tape” on behalf of the patient. 3. Responds to patients, in writing, resolutions to the patient’s grievances in a timely manner; provides a detailed file and written response in accordance with Federal Law and policy in response to regulatory agencies, patients, family members and other entities conducting investigations or requiring a response. 4. Coordinates efforts to collect, analyze, and evaluate consumer satisfaction data; utilizes feedback to facilitate systems improvements to better meet the consumer’s needs; reports and plans with the Vice Presidents, CAO’s or Directors in developing improvement plans for departments and organization. 5. Provides expertise on customer needs and expectations and acts to educate staff and physicians concerning these issues. 6. Tracks complaint/compliment information through the MIDAS system, identifies trends, reports trends, potential patient safety issues, and potentially compensable events by coordinating with Risk Management when the incident rises to the level of possible litigation or financial mediation. 7. Collaborates with CAOs, Directors, staff and the Medical Staff to resolve complaints and concerns from our patients, family members, physicians, visitors, etc., in a systematic manner in coordination with Quality, Risk Management, Administration, Patient Financial Services and other department leaders that are involved in the resolution of the patient complaint/concern. 8. Identifies potential compensable events and coordinates a strategy with Risk Management for possible resolution. 9. Coordinates investigations regarding quality of care issues with the Quality Services department for possible peer review activities. 10. Champions Patient Rights and Organizational Ethics; provides assistance with implementation of Joint Commission Standards and/or State and Federal laws pertaining to Patients’ Rights, Advance Directives, and the Americans with Disabilities Act and/or ethical issues. 11. Performs other duties as assigned.