Patient Grievance Coordinator

Yale New Haven Health•New Haven, CT

About The Position

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. The patient grievance coordinator ensures that the organization is in compliance with regulatory body requirements for the management of patient complaints and grievances. Works closely with patient relations leadership to ensure that patient representatives maintain compliance with the Center for Medicare and Medicaid Services (CMS) standards in documentation and grievance follow-up. Serves as the lead person for the investigation, reporting, and resolution of patient grievances. Is responsible for ensuring that the hospital is in compliance with CMS Conditions of Participation related to patient grievance management. Serves as liaison between patients, families, visitors, hospital staff, and medical staff. Enhances patient and family awareness of the institution's responsiveness to concerns. Displays the hospital's overall commitment to exceptional delivery of patient care by imparting a caring attitude and prompt responsiveness, which is critical to the continued success of the organization. Serves as an institutional leader in patient relations. Is responsible for regular reports to the patient grievance committee and for the preparation and distribution of the patient grievance committee agenda and meeting records. EEO/AA/Disability/Veteran

Requirements

Bachelor's Degree in Human Services, Public Relations, Communication, or related field required.
Five (5) to seven (7) years? experience in a healthcare setting which includes extensive experience in patient relations/patient satisfaction.
Demonstrated experience in complaint resolution, coordination and interaction with senior staff and the medical community.
Excellent interpersonal, verbal, and written communication skills.
Demonstrated emotional maturity in interaction with others.
Ability to work independently.
Proven history of ability to handle sensitive and highly confidential issues.
Must have proven history of exemplary customer service skills, including de-escalation techniques.
Must demonstrate understanding and be able to communicate clearly regarding billing issues as related to quality of care.
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. They are frequently required to reach with hands and arms. They are also required to stand and walk. They must occasionally lift and/or move up to 25 pounds. Specific vision abilities required include close vision, distance vision, color vision, peripheral vision, and depth perception. The noise level in the work environment is usually moderate. Must be able to adhere to the requirements of the role. Incumbents, as well as external and internal applicants who become disabled, must be able to perform the essential job functions with or without the assistance of reasonable accommodation as determined on a case-by-case basis

Nice To Haves

Master's Degree highly preferred.

Responsibilities

Manages the patient grievance process, ensuring that CMS guidelines and health system/physician enterprise polices are adhered to and that patients are responded to within CMS designated time frames, with adequate detail to address concerns.
Ensures that patient representatives adhere to patient grievance process and timelines.
Manages the daily flow of all patient grievances.
Makes personal contact with patients who have filed grievances.
Investigates all patient grievances by researching concerns with medical staff, nursing staff, and other pertinent staff, including the review of medical records and other records as needed.
Serves as role model for collaborative, cooperative interactions with all persons, both within and outside the department
Facilitates and coordinates the patient grievance committee meetings by scheduling, facilitating, and providing meeting records for distribution among committee members.
Responsible for written responses to patient grievances, according to CMS guidelines for content and timeliness. Reviews responses drafted by patient representatives and ensures that responses are well-written and reflect investigation of each issue presented by grievant.
Provides monthly reports to patient grievance committee, including trending and analysis of patient concerns through grievances. Prepares annual summary of patient grievance activity for reporting to administration.
Facilitates patient and family meetings with hospital personnel to resolve patient grievances. Prepares hospital personnel for meetings and provides written resolution to patients/families.
Makes referrals as appropriate to patient experience and engagement managers for possible patient and family advisors.
Other duties as assigned.