Patient Relations Specialist II

OU Health•Fredericksburg, VA

About The Position

The Patient Relations Specialist II supports system-wide patient and visitor quality and experience efforts by applying high reliability principles in daily work. This role supports the Patient Relations team and serves as a subject matter expert in service recovery, documentation, investigation, and resolution of patient and visitor complaints and grievances. The specialist helps ensure timely, effective responses that meet regulatory requirements and advocates for a culture of safety for patients, workforce members, providers, and visitors. The position works with patients, representatives, healthcare teams, leadership, and other stakeholders to address concerns, conduct investigations, document feedback, identify trends, and recommend or coordinate appropriate escalations. It also contributes to department initiatives, committee work, onboarding, and training.

Requirements

Bachelor's degree.
Three years of experience in a healthcare position involving direct patient and family interactions, or three years of experience in risk management involving direct navigation of patient and visitor complaints with regulatory oversight.
Ability to review patient medical records in an electronic health record.
Working knowledge of service recovery and de-escalation techniques.
Proficiency in written communication and letter composition.
Strong communication skills with diverse populations, including strong telephone and verbal communication skills.
Excellent interpersonal and collaboration skills, including the ability to work with executive leaders.
Demonstrated knowledge of patient safety principles.
Computer proficiency, including Microsoft Office products.
Analytical thinking, sound decision-making, critical thinking, and problem-solving skills.
Ability to work in a challenging, rapidly changing, fast-paced environment with multiple high-priority deliverables.
Resilience and ability to handle difficult interactions without further escalating situations.
Emotional intelligence and awareness, and ability to multitask routinely.
Ability to speak publicly in team or committee settings.
Professional appearance and willingness to meet complainants or representatives in person in a hospital setting.
Self-starter who can be highly productive with minimal supervision.
Ability to demonstrate empathy toward patients and their representatives.
Fluency in spoken and written English and ability to navigate communications through translation services as needed.

Responsibilities

Support the daily operations of the Patient Relations team, including responding to patient and visitor complaints received through all modalities.
Review daily files in Patient Relations software and assess files submitted by others to determine whether complaints should be escalated to grievances.
Use service recovery and de-escalation techniques to help complainants navigate the complaint process.
Help ensure grievance acknowledgement and resolution letters are completed within policy and regulatory timelines.
Compose and mail grievance acknowledgement and resolution letters, valuables reimbursement letters, and other communications.
Enter and maintain accurate data in Patient Relations software and monitor feedback trends by location, volume, concern type, and response effectiveness.
Communicate trends and areas needing attention to leadership.
Conduct and guide grievance investigations, including advising unit leadership, interviewing involved personnel, reviewing charts, and facilitating debriefings.
Review concerns and determine whether further escalation is needed, including referrals to Patient Safety and Regulatory, Ethics and Compliance, Human Resources, or service line executive leadership.
Escalate allegations of abuse, assault, or neglect to appropriate stakeholders or law enforcement as required by policy.
Maintain working relationships with Legal and Claims services to manage risk related to complaints and grievances.
Collaborate with system-wide stakeholders to resolve complaints and grievances and report outcomes.
Serve on committees as a subject matter expert and contribute to recommendations regarding billing adjustments based on case knowledge and patient experience.
Support Patient Relations leadership with preparation, facilitation, and note-taking for the OU Health Complaints and Grievances Committee as needed.
Advocate for patient and visitor requests and concerns through effective communication with appropriate OU Health personnel and healthcare teams.
Make professional, respectful recommendations to support resolution of concerns.
Serve on teams or committees as a subject matter expert regarding patient appeals of dismissal from clinical practices, as needed.
Comply with OU Health flu vaccination and TB testing policies, as applicable.
Document complaints clearly and accurately, making every effort to represent the complainant's perspective in good faith.
Maintain working knowledge of applicable rules, regulations, policies, laws, and guidelines affecting Patient Relations.
Follow internal controls and processes supporting compliance with laws, accrediting requirements, and federal, state, and private health plans; escalate concerns or recommendations through appropriate channels.
Seek advice and guidance when needed to ensure proper understanding of duties.
Assist with onboarding and training new personnel as needed.
Perform other duties as assigned.