Patient Advocate

Carilion Clinic•Roanoke, VA

6d•Onsite

About The Position

This position will provide frontline risk management through the intake, investigation, and either resolution or escalation of complaints and grievances from patients, family members, and visitors. The Patient Advocate will exercise autonomy in determining the optimum method of management to ensure the best possible outcome for all involved. The Patient Advocate will also provide support to Carilion Clinic staff by assisting with communication between staff and patients and families and acting as liaison when appropriate. The Patient Advocate will utilize critical thinking and advanced problem-solving skills. Promotes Carilion Clinics Culture of Service Excellence and quality through teamwork, respectful communication, maintenance of a professional environment, partnership with those we serve, and anticipation of patient/customer needs. Applies communication skills, de-escalation techniques, and resolution strategies to the management of patient, family, and visitor complaints and grievances. Receives and process calls, letters, visits or other notifications of complaints. Reports potential claims to the Director of Patient Advocacy as needed. Investigates complaints by actively working with managers/directors of affected areas to determine issues. This includes talking with care givers or other staff involved in the care of the patient. Determines the location of the event incident, requesting medical records, obtaining release from patient for access to medical records from outside facilities, when necessary. Meets with patients, families or involved persons and investigates complaints and concerns. Determine completeness of complaint response and forwards the information to Director for final review. Drafts letters to patients and families and prepare for Director's signature. Following the investigation of a complaint/grievance determines the appropriate disposition for that complaint /grievance (resolution, escalation, or response and closure). Works with appropriate internal and external resources to effectuate disposition as necessary. Works within the parameters established by departmental policy. Proactively provides education and support to patients, families, visitors, providers, and staff through regular rounding in clinical areas and practice sites. Educates and orients staff regarding the Department of Patient Advocacy and provides other educational opportunities as appropriate. Provides accurate and up-to-date complaint and grievance information to the Director on a monthly basis for incorporation into report to Grievance Committee. Reports on directly to the Grievance Committee regarding specific issues or initiatives on an as needed basis. Personally escorts patients, employees or families as indicated to the appropriate locations. Provides support to Guest Services as appropriate.

Requirements

High school diploma or GED required, Bachelors preferred.
One year of experience in a patient care or customer service area.
Five (5) years with Service Recovery or Dispute Resolution.
3,000 hours or 50 percent of full-time job duties within the last three years dedicated to healthcare risk management in a healthcare setting or with a provider of services (e.g. consultant, broker, or attorney) to the healthcare industry.
Maintains Notary Public designation.
CPHRM Certification within one (1) year.
Effective interpersonal, communication and teamwork skills required.
Must successfully complete orientation.
Demonstrated history of compliance and confidentiality required.
Demonstrated ability to communicate well in challenging situations.
Often communicates with state, legal and other representatives and serves as a front-line contact.
Tools used may include but are not limited to Microsoft Word, Power Point, Excel, SMS, SoftMed.

Responsibilities

Provide frontline risk management through the intake, investigation, and either resolution or escalation of complaints and grievances from patients, family members, and visitors.
Exercise autonomy in determining the optimum method of management to ensure the best possible outcome for all involved.
Provide support to Carilion Clinic staff by assisting with communication between staff and patients and families and acting as liaison when appropriate.
Utilize critical thinking and advanced problem-solving skills.
Promote Carilion Clinics Culture of Service Excellence and quality through teamwork, respectful communication, maintenance of a professional environment, partnership with those we serve, and anticipation of patient/customer needs.
Apply communication skills, de-escalation techniques, and resolution strategies to the management of patient, family, and visitor complaints and grievances.
Receive and process calls, letters, visits or other notifications of complaints.
Report potential claims to the Director of Patient Advocacy as needed.
Investigate complaints by actively working with managers/directors of affected areas to determine issues.
Determine the location of the event incident, requesting medical records, obtaining release from patient for access to medical records from outside facilities, when necessary.
Meet with patients, families or involved persons and investigates complaints and concerns.
Determine completeness of complaint response and forwards the information to Director for final review.
Draft letters to patients and families and prepare for Director's signature.
Determine the appropriate disposition for that complaint /grievance (resolution, escalation, or response and closure).
Work with appropriate internal and external resources to effectuate disposition as necessary.
Work within the parameters established by departmental policy.
Proactively provide education and support to patients, families, visitors, providers, and staff through regular rounding in clinical areas and practice sites.
Educate and orients staff regarding the Department of Patient Advocacy and provides other educational opportunities as appropriate.
Provide accurate and up-to-date complaint and grievance information to the Director on a monthly basis for incorporation into report to Grievance Committee.
Report on directly to the Grievance Committee regarding specific issues or initiatives on an as needed basis.
Personally escort patients, employees or families as indicated to the appropriate locations.
Provide support to Guest Services as appropriate.