MAJOR FUNCTION:

Responsible for the complaint/grievance management process. Works collaboratively with leadership to conduct complaint/grievance investigation; refers complaint/grievance appropriately; facilitates complaint/grievance resolution; documents all processes in appropriate data base; requests action plans as needed. Escalates concerns to the Director when necessary.  Regulates organizational compliance with all patient rights laws/standards. Working alongside the Patient Relations Managers for each building, this position oversees a number of network responsibilities including but not limited to reputation management, safety coach for the department, and acting as a resource when Patient Relations Managers need support in facilitating cases.

QUALIFICATIONS:

Education & Experience:

Bachelor’s Degree required.Master's preferred.  Prior experience with patient advocacy, and complaint/grievance management in healthcare setting required.

Certification/Licensure: 

Certified Patient Experience Professional preferred.

Knowledge & Skills:

Must have exceptional interpersonal and problem-solving skills.Bilingual preferred.  Willingness to certify for Notary Public in NJ. Ability to work within a multidisciplinary team and multicultural environment.Ability to defuse stressful situations and resolve issues.Excellent communication, writing and presentation skills.Proficiency in Microsoft Office, including Excel.

Position Responsibilities

Integrates Department Services with IMG, Urgent Care and Ambulatory Imaging' Primary

Function:

• Initiates meetings with colleagues as needed for planning and problem solving.

• Assists Department Director with development of annual department goals and objectives

in conjunction with organization's mission and goals.

• Maintains communication with other departments.

• Assures completion of projects with timely implementation.

• Develops, and monitors action plans for projects in process.

• Develops, reviews and monitors departments-program for planning safe environment of

care.

• Actively participates in patient safety initiative; including safety call, HRO training,

accreditation audits and all other necessary safety measures.

Conducts Problem Resolution:

• Resolves patient/family complaints through unbiased personal fact gathering and

discussion with concerned parties.

• Works collaboratively with leadership (nursing, risk management, human resources, legal

and others) to investigate allegations through discussion with involved staff and resolves

as appropriate based upon results of investigation.

• Conducts follow-up according to INSPIRA Policy and CMS guidelines.

Monitors Customer Comments:

• Reviews patient surveys for initiation of patient grievance process, patient contact &

problem investigation/resolution.

• Contact person for patient surveys with high priority comments. Performs necessary

follow-up.

Patient Experience:

• Must regularly review Patient Experience scorecards on a monthly basis and be prepared

to speak to the organization's current performance if asked by staff.

• Attend Campus level Patient Experience Meetings.

• Help lead Patient Experience teams/initiatives.

Troubleshooting:

• Conducts daily patient visitation throughout inpatient and outpatient areas to meet and

greet patients and their families in order to assess patient satisfaction, and attempt resolve

any concerns in their early stages.

• Meets with walk-in customers regarding complaints/grievances.

• Work with physician offices to assure continuation of care for medically indigent patients.

• Oversees Service Recovery program and utilizes (encourages utilization) as needed.

Maintains Records of Patient Concern Information:

• Responsible for oversight of concern log and records of patient concern information,

including retention of records for a minimum of seven years.

• Responsible for maintaining compliance over complaint and grievance process for their

cases, timely acknowledgement (within 7-10 days) timely response (within 30 days)

interim letters if delay in timely response. Follow up with appropriate departments to close

the complaints per CMS guidelines.

Ensures Adherence to and Upholding of Patient Rights:

• Oversees hospital's compliance of Patient Rights.

• Monitors the system-wide implementation of patient rights.

• Oversees system wide Language Services for LEP and Deaf/Hearing Impaired patients.

Provides Input for Patient-Focused Process Improvements:

• Makes recommendations for operations improvement (process improvement) to Network

Manager /Administrative Director of Patient Relations and elevates to Senior Management

Level when appropriate.

• Assists Managers/Directors with action plans as necessary.

• Provides feedback from observations, and/or complaint/grievance data trends.

Uphold and Maintains the Service Excellence Model:

• Communicates effectively and in a proper environment with patients, visitors, staff,

physicians, volunteers, and management in a manner that is perceived by others as

courteous, friendly, tactful, and caring using iCare model when appropriate.

• Shows willingness to assist others as needed or indicated.

• Respects patient/employee confidentiality.

• Conduct is mature, respectful, and pleasant.

• Displays professional behavior at all times.

• Actively participates as a member of the health care team.

• Supports the corporate culture.

Physical Requirements: 
N: Never       O: Occasionally (<20%)       F: Frequently (20%-80%)       C: Constantly (>80%)Lifting <20lbsOStandingFSittingFLifting 20-50lbsNClimbingNKneelingNLifting>50lbsNCrouchingOReachingOCarryingNHearingCWalkingFPushingNTalkingCVisionC Environmental Conditions:NoiseFVaried TemperaturesOCleaning AgentsONoxious odorsFPatient ExposureFOperative EquipmentO

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