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Bozeman Health PATIENT RELATIONS SPECIALIST in Bozeman, Montana

  • POSITION DESCRIPTION

  • POSITION SUMMARY

  • The Patient Relations Specialist is to promote awareness and commitment to the deliverance of an effective grievance resolution process in accordance with CMS conditions of participation and accreditation standards. The Patient Relations Specialist represents the organization in response to electronic and onsight patient complaint surveys by the Accrediting Body or CMS. They are to be an advocate for the patients and patient representatives by maintaining an understanding of patient rights and responsibilities. Responsibilities include supporting leadership in successfully investigating, documenting, routing, and following up on patient and family complaints and grievances efficiently and within the required timeframes.

Additionally, this position will be responsible for collecting, analyzing, and reporting on key statistical data related to grievances and complaints; chairing and managing the grievance committee, designing and presenting a comprehensive leadership education program to ensure leadership's competence with managing patient grievances to achieve best outcomes.

This position requires a high degree of diplomacy and tact as they will be interacting with people at all organizational levels within the system, as well as outside of the organization. A high level of factual dependability and accuracy will be required to be successful in this role.

  • REQUIREMENTS

  • EDUCATION

  • Required:

    • Bachelor's Degree
  • Preferred:

    • Master's Degree
  • LICENSURE and CERTIFICATION

  • Required:

  • Preferred:

    • Registered Nurse, Case Manager, Licensed Clinical Social Worker
  • EXPERIENCE

  • Required:

    • 4 years in a healthcare setting working directly with patients and family members
  • Preferred:

    • Knowledge of operations and clinical procedures/workflows in hospital, outpatient, and ambulatory settings. Ability to navigate an electronic health record.
  • KNOWLEDGE OF, SKILLS IN, ABILITY TO, COMPLEXITY AND DIFFICULY:

  • KNOWLEDGE OF:

    • Customer service recovery techniques and approach
  • Regulations and industry standards pertaining to grievance resolution

  • Clinical, Support, and Patient Financial Services workflows and EHR documentation

  • Regulatory and industry standards pertaining to patient experience (HCAHPS, CGCAHPS, etc.)

  • SKILLS IN:

    • Documenting and managing continuous improvement projects to achieve desired outcomes and reduce grievance recurrence
  • Technical and professional writing to draft patient and family letters

  • Strong, dynamic communication skills when working with patients, families and leadership that relays a support-filled advocacy

  • Engaging key stakeholders in monitoring metrics, analyzing results, and improving broken processes associated with grievances

  • Leading interdisciplinary groups to accomplish specific goals associated with corrective action plans and continuous improvement projects

  • Establish and maintain project timelines/deadlines for achieving compliance to the grievance resolution policy and CMS Conditions of Participation

  • Teaching, using various adult learning principles

  • ABILITY TO:

    • Set an agenda for and run a system wide grievance resolution committee, while also documenting minutes using Quality Management principles
  • Reference regulations and industry standards to serve as subject matter expert in grievance resolution process

  • Maintain flexibility to adapt to a variety of workload assignments and leading others to effectively advocate for all patients who file grievances

  • Maintain confidentiality

  • COMPLEXITY AND DIFFICULTY:

    • Work independently with a minimum of Supervision
  • Team oriented and self-motivated

  • Utilize resources efficiently

  • ESSENTIAL FUNCTIONS

  • 60% Time Spent -

  • The Patient Relations Coordinator works with executives, directors, managers, physicians, and staff to facilitate resolution in accordance with our policy and procedure by monitoring and documenting all complaints and grievances in Midas. Drafts professional letters and uses dynamic communication approaches to ensure the patient remains frequently apprised thought the entire resolution process.

  • 20% Time Spent -

  • Coordinates complex patient relations problem solving between departments. Works collaboratively with Risk Manager, Patient Safety Coordinator, Medical Staff and organizational leaders to conduct RCA, and fix process issues related to quality of care. Initiates escalation procedure as needed to meet patient expectations and remain in compliance with CMS CoP.

  • 10% Time Spent -

  • Organizes and leads quarterly grievance committee meeting with members to include setting agenda, documenting minutes, and sharing scorecard, dashboard, and graph trends and analyses. Participates in process improvement projects and provides input regarding patient care complaints to the appropriate committees, taskforces, etc.

  • 10% Time Spent -

  • Provides education and guidance to the responsible Leadership and Medical Staff related to patient relations and the grievance processes. Orienting new users to Midas for both risk and patient complaint occurrence reports.

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