Grievance Coordinator

Frederick Health•Frederick, MD

22h•Onsite

About The Position

The Grievance Coordinator is responsible for coordinating, supervising, and ensuring the timely resolution of patient grievances in accordance with CMS Guidelines and FH Policy. This role involves collaboration with Performance Improvement, Risk Management, Accreditation, and Regulatory Compliance teams. The Coordinator must support and incorporate the Frederick Health (FH) mission, vision, core values, and customer service philosophy into their job performance, adhering to the FH Compliance Program, regulatory requirements, and FH Standards of Behavior.

Requirements

Able to prioritize multiple demands.
Excellent customer service skills with demonstrated ability to effectively meet customer’s expectations
Conflict management skills
Excellent oral and written communication skills
Demonstrates effective time management and organizational skills
Ability to guide and/or facilitate a team and promote positive interactions across departments.
Experience with cost analysis and patient accounts required.
Familiar with MS office products to include Word, Excel and PowerPoint
Graduate of an approved Bachelor Degree program in Nursing, or Health Care Administration with 3-5 years of clinical experience.

Responsibilities

Ensures prompt response to grievances from patients and families submitted by telephone call, written letter, email, fax, or interview.
Ensures prompt response to requests for information from the State of Maryland, CMS, The Joint Commission, or other third party companies related to patient/family complaints.
Efficiently and accurately enters concerns, as appropriate, into the Event Reporting System.
Investigates grievances by literature research, medical record review, consultation with content experts, and interviews with involved staff/providers and patient/family members.
Processes grievances in accordance with regulations, requirements, and established time frames set by CMS, the State of Maryland, and The Joint Commission.
Develops a written response to each grievance which is then sent to the complainant within the designated timeframe.
Works with appropriate personnel, physicians, hospital staff, leadership, and the patient/family member to facilitate appropriate follow-up and ensure resolution of concerns and complaints.
Initiates peer review process when indicated.
Collaborates with Patient Financial Services to make account adjustments as appropriate.
Coordinates with Risk Manager on any potentially litigious situation that is identified during the course of the grievance investigation.
Manages grievance database and produces reports to demonstrate compliance with regulatory standards.
Provides written reports including a summary of activity by the number and type of concerns, complaints, and grievances received, as well as the resolution status of all cases.
Develops and coordinates the presentation and communication of grievance data to organizational stakeholders.
Identifies trends in patient concerns and complaints, communicates information about trends to organizational stakeholders, and collaborates with organizational team members to develop action plans to resolve common concerns.
Sets a positive professional example for others; serves as a role model and mentor.
Effectively communicates and collaborates with colleagues, multidisciplinary team and customers.
Is detail-oriented and follows through with projects and requests.
Takes ownership of problems and displays initiative to resolve issues.
Achieves results on time by focusing on priorities and managing time efficiently.
Empowers staff, treats others with fairness, kindness and respect for personal dignity and privacy.
Actively participates in cost containment by providing input with needs and areas of waste.
Answers incoming calls to Service Excellence Department.
Sorts, logs, and facilitates return of items turned in to the Lost and Found.
Monitors and promptly responds to emails sent to the [email protected] email address.
Other duties as assigned.