Patient Advocate

Carilion Clinic•Roanoke, VA

About The Position

The Patient Advocate provides frontline risk management by receiving, investigating, resolving, or escalating complaints and grievances from patients, family members, and visitors. The role requires autonomy in determining an appropriate approach to achieve the best possible outcome and supports Carilion Clinic staff by facilitating communication between staff, patients, and families and serving as a liaison when appropriate. The Patient Advocate uses communication, de-escalation, and resolution strategies to manage complaints and grievances. The role includes documenting issues and actions taken in keeping with regulatory requirements, reporting potential claims, investigating concerns with affected departments and staff, meeting with patients and families, and determining appropriate dispositions. The Patient Advocate also supports complex cases, service recovery, staff education, patient and family navigation, and reporting to the Grievance Committee.

Requirements

High school diploma or GED required.
One year of experience in a patient care or customer service area required.
Maintains Notary Public designation.
Effective interpersonal, communication, and teamwork skills.
Demonstrated history of compliance and confidentiality.
Ability to communicate effectively in challenging situations, including interactions with state, legal, and other representatives while serving as a frontline contact.
Proficiency with Microsoft Office.

Nice To Haves

Five years of experience in Service Recovery or Dispute Resolution may be considered.
Alternatively, 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 to the healthcare industry may be considered.

Responsibilities

Receive and process complaints and grievances submitted by calls, letters, visits, or other notifications.
Use communication skills, de-escalation techniques, and resolution strategies to manage complaints and grievances.
Report potential claims to the Manager or Director of Patient Advocacy as needed.
Maintain thorough, precise documentation of identified issues and resolutions or actions taken in compliance with regulatory requirements.
Serve as patient liaison for Treatment Appropriateness Review Committee (TARC) and Synchronized Ongoing Support (SOS) complex cases requiring significant management.
Investigate complaints in collaboration with managers and directors of affected areas, including speaking with caregivers and other staff involved in patient care.
Determine the event location, request medical records, and obtain patient releases for records from outside facilities when necessary.
Meet with patients, families, and other involved persons to investigate complaints and concerns.
Use a rounding tool to document feedback from patients, visitors, and families.
Determine whether complaint responses are complete and forward information to the Clinical Risk team for final review.
Determine whether complaints and grievances should be resolved, escalated, or answered and closed, and work with internal and external resources to carry out the disposition.
Work within departmental policy parameters.
Provide education and support through regular rounding in clinical areas and practice sites.
Educate and orient staff about the Department of Patient Advocacy and provide other educational opportunities as appropriate.
Collaborate with healthcare team members, regulatory agencies, and third-party organizations to help patients and families navigate the healthcare system.
Provide accurate, current complaint and grievance information to the Director monthly for reports to the Grievance Committee, and report directly to the committee on specific issues or initiatives as needed.
Escort patients, employees, or families to appropriate locations when indicated and support Guest Services as appropriate.
Act as a patient liaison in systemwide service recovery, including ambulatory sites and community hospitals.
Partner with community-hospital Quality Directors to resolve patient complaints and grievances.
Stay informed about proposed regulatory or process changes.
Assist Carilion Clinic staff with communication between staff, patients, and families and act as a liaison when appropriate.