Under general supervision, performs comprehensive triage of complaints, incident/accident, and facility reported incidents (FRI's) according to Medicare/Medicaid certification and State standards for compliance with Federal, State, and other applicable laws and regulations for Healthcare Quality. Reviews complaint allegations and assures that they are appropriately logged. Triages complaints received utilizing Healthcare Quality protocols. Review of incident and accident reports. Prepares complaint intake documentation and researches and responds to queries from Regional Long-Term Ombudsman. Determine the scope of complaints and inquires in accordance with Healthcare Quality guidelines. Meets deadlines with effective and complete written correspondence, documentation, and data entry. Participates with other team members and members of other program areas to identify concerns, solve problems, and make decisions in a rational process. Assist with quality improvement planning when requested and attends team meetings when needed. Provides clinical information and guidelines to staff when requested. Ability to apply critical thinking to triage complaints, incident/accident, and FRI's. Performs other duties as necessary, including but not limited to participates in preparing and presenting for hearings and trials. Review of Informal Dispute Resolution (IDR) and Independent Informal Dispute Resolution (IIDR) request when needed.
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Job Type
Part-time
Career Level
Mid Level
Education Level
Associate degree