Patient Representative II - CLC Patient Services (Onsite)

UTMB Health•Webster, TX

1d•Onsite

About The Position

The Patient Representative II provides an excellent patient and family experience by investigating complaints across UTMB Health settings. Complaints may concern care provided by physicians and other healthcare professionals, potential liability, quality of care, hospital policies and procedures, or other sensitive matters requiring extensive conflict resolution with patients and families. The role supports patients, families, and staff in seeking satisfactory resolutions and works to resolve complaints at the most appropriate level within the organization. The position manages a large caseload of inquiries, conducts detailed investigations, prepares formal written responses on behalf of UTMB Health, and maintains departmental records for tracking and accountability. It also initiates corrective actions and recommends policy, process, quality, safety, billing, or other improvements to enhance the patient experience. The Patient Representative II communicates with patients, families, and staff and may coordinate or participate in conferences to develop agreements for challenging or non-compliant patients. The role also serves as a resource on patient rights and responsibilities, including matters such as Advance Directives and DNR wristbands.

Requirements

Bachelor’s degree or equivalent.
Four years of experience in social services, clinical care, or clinical operations settings.
Experience advising patients or customers of their rights and assisting them with resolution of their issues.

Responsibilities

Investigate patient complaints, mediate complex disputes, and de-escalate potentially volatile interactions between patients or families and faculty or staff.
Conduct case investigations, including clarifying issues, reviewing medical records and policies and procedures, and interviewing patients, families, and staff.
Provide assistance and support to patients, families, and staff who contact the Patient Services Department, seeking satisfactory resolution whenever possible.
Resolve complaints at the most appropriate level within the organizational structure and interact with personnel at all levels.
Manage a large caseload of patient inquiries requiring extensive follow-up, including highly sensitive cases.
Prepare formal written responses on behalf of UTMB Health and maintain departmental records for tracking and accountability.
Initiate corrective action for individual complaints and organizational processes, including recommendations concerning policies and procedures, quality and safety initiatives, billing adjustments, or other dispositions.
Communicate effectively and professionally with patients, families, and staff in writing and verbally.
Coordinate and participate in patient/staff conferences, as negotiated with the care team, to develop contracts for challenging and/or non-compliant patients.
Advise internal and external customers on interpreting patient rights and responsibilities, including Advance Directives and DNR wristbands.