Patient Representative Services Specialist
: Job Details :

The best thing about this role Are you looking to make a difference by improving the health of our patients? Here you will find an innovative culture that is patient-focused and dedicated to making a difference. We are committed to helping the population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible. What you'll do The Patient Representative Services (PRS) Specialist is a key organizational resource in connecting patients with departmental managers and directors, throughout the network, in ensuring patient and visitor complaints are resolved in a way which improves patient satisfaction, prevents the escalation of events, protects the organizations reputation, reduces the likelihood of legal action, and ensures compliance with New York State, TJC, and CMS regulations. The PRS Specialist collects and analyzes data regarding patient and family complaints, providing data for Board Committees, Safety Committees, Executive Leadership, Clinical Leadership and managerial staff. Facilitates patient response letters, escalates response timing to meet regulatory requirements. Serves as subject matter expert in all areas of grievance and complaint resolution including the electronic RL6 Feedback module. Serves as a liaison between patients and all departments of the network including but not limited to clinical, patient support, nursing and financial. Develops processes to track and reduce overdue grievance responses from throughout the network. Responsible for all aspects of final grievance responses, ensuring thoroughness, courtesy, and empathy. Analyzes data, recognizes and reports trends to all levels of the organization including the Board. Prepares reports to identify areas of opportunity which impact patient safety, satisfaction, and organizational reputation to clinical leadership. The PRS Specialist is responsible for identifying systems opportunities. Serves as the patient advocate at Bassett Healthcare and serves as a representative of Bassett Healthcare to patients and family. This position is responsible for ensuring that patient/visitor concerns or grievances are processed and resolved in a timely manner in accordance with the governing standards, rules and regulations. The Specialist is responsible for the complaint/grievance process throughout the network (including the hospital, clinics and health centers). The Specialist analyzes feedback and identifies systematic opportunities and is essential in co-creating improvements. The Specialist is an integral part of a multidisciplinary team and collaborates with unit leadership, medical staff leadership, medical education leadership, and administration to meet customer service, clinical quality outcomes and regulatory requirements. In addition, the Specialist will participate on committees, work groups, and/or process improvement teams which work to improve patient/customer satisfaction, uphold patient rights, and improve the patient experience. Performs all functions of the Patient Representative Services Specialist. Explains the policies, procedures and services to patients and employees, relevant to the Grievance and Complaint Process. Maintains expert knowledge and shares knowledge regarding CMS, TJC and NYSDOH regulations, related to grievances and complaints, with all levels of the organization, including leadership and board members. Maintains expertise in RL6 Feedback system, serves as an organizational resource for helping members of leadership use the system. Maps appropriate leadership resource to receive information in the RL6, assures mapping is updated as leadership responsibility change. Develops reports for organizational leadership for complaint trending and programmatic corrective actions. Compiles reports of complaints and grievances as requested. Recognizes potential regulatory violations, and/or quality of care concerns and reports them immediately to the appropriate director. This includes, but is not limited to complaint and grievance, HIPPA, and CMS early discharge issues. Develops and uses escalation process to assure CMS and NYS requirements for timely resolution of grievances are met. Coordinates communication between patients, family members, medical staff and administrative staff. Interviews patients or their representatives to identify problems relating to care. Directs patient inquiries or complaints to the appropriate personnel and follow up to ensure satisfactory resolution. Facilitates resolution of complaints and grievances for patients & visitors in accordance with the Centers for Medicare and Medicaid Services Conditions of Participation, The Joint Commission, and the NYSDOH. Ensures accuracy and completeness of PRS database. Collaborates with unit leadership to meet customer service outcomes with real time service recovery. Documents patient or visitor concerns to include demographic data, synopsis of the incident, actions taken to resolve the outcome, service area, and all relevant categories and ensures the database is current and updated. Acts as organizational liaison for investigation and resolution of missing property complaints and incidents. Assists in the development of monthly and quarterly reports for the grievance committee, Performance Improvement Committee, Medical Staff Leadership and additional ad-hoc reports as requested. Coordinates the grievance appeals with the Medical Director as needed. Develop a consultant relationship with assigned areas to build and sustain a patient/customer-focused culture. Assists in the resolution of complaints and grievances involving multi-facility issues. Identifies and elevates complaints/grievances in which there might be the potential for legal liability. Coordinates interventions/services with the Director of Patient Safety and Risk Management as applicable Keeps director informed of barriers to complaint resolution, inadequate responses and response time delays. Performs similar or related duties as requested or directed. What we need from you Education: 2 Year / Associate Degree relevant healthcare experience, required Experience may be considered in lieu of education Experience: Healthcare environment experience, required Skills: Computer Skills Data Management Communication Project Management/Planning Interacting with People Self-Motivated Listening Physical Requirements: Sedentary Work - Exerting up to 10 lbs of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking or standing are required only occasionally, and all other sedentary criteria are met. Occasional kneeling, lifting, pulling, pushing, reaching, standing, walking Frequent typing/clerical/dexterity, hearing, repetitive motions, seeing/monitor/computer use, talking, visual acuity Travel: Occasional Travel - The job may require travel from time- to-time, but not on a regular basis Total Rewards Bassett Healthcare Networks commitment to our employees includes benefit programs carefully designed with the needs and values of all our employees in mind. Many of the benefits we offer are paid fully or in large part by Bassett. Our generous benefits offerings include: Paid time off, including company holidays, vacation, and sick time Medical, dental and vision insurance Life insurance and disability protection Retirement benefits including an employer match And more! Specific benefit offerings may vary by location and/or position. Pay Range Salary is based on a variety of factors, including, but not limited to, qualifications, experience, education, licenses, specialty, training, and fair market evaluation based on industry standards. The above compensation range represents a good faith belief of the compensation range by Bassett Healthcare Network, and its entities and affiliates, at the time of this posting or advertisement. Pay Range Minimum: USD $22.85/Hr. Pay Range Maximum: USD $34.28/Hr. We love the difference people bring We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status as a victim of domestic violence, or any other status protected by law.