Primary City/State:

Mesa, Arizona

Department Name:

Work Shift:

Day

Job Category:

Risk, Quality and Safety

POSITION SUMMARY
This position is primarily responsible to steward patient complaint/grievance cases to resolution and writing their own correspondence as required for regulatory compliance. Ensures privacy and confidentiality of the patient according to HIPAA and privacy laws. Responsible for addressing patient relations issues across multiple entities from a centralized location to turn any problems into opportunities that result in positive outcomes. Primarily responsible for addressing more complex issues that arise when a patient or family member is not physically present at a Banner entity through a variety of modes, such as letters, calls, emails, satisfaction surveys, etc. The RN Patient Relations Coordinator is responsible for treating all customer incidents in a compassionate manner, properly documenting the issues in our electronic database and serving as project manager to ensure timely resolution. This could include grievance identification and resolution, serving as a liaison between patients/family members, facility staff or credentialed provider, and acting as a liason with other relevant partners such as regulatory and clinical risk management, in an effort to provide missing information and to build and maintain mutually beneficial relationships with patients, their families and key constituencies, resulting in enhanced patient/family experience. This also includes follow up with patient by phone and/or in a written document once we have a resolution with the goal to create a positive experience.

CORE FUNCTIONS
1. Intakes and documents all issues relayed by the patient or family member and investigates, documents and coordinates resolution of service quality concerns assigned to them in this role which may be clinical and non-clinical in nature. This includes ensuring all policies, procedures and processes are followed to achieve timely resolution of service and care related complaints and grievances, including reviews of patient records, escalations and adhering to applicable system guidelines and regulatory requirements.

2. Communicates directly with clinical and senior executive leadership to obtain thorough investigative findings in response to all stated concerns. Ensures entity has contacted patient to address stated concerns. Coordinates needed information to facilitate the completion of a letter to patient as needed. Must also ensure privacy and confidentiality of the patient by complying with HIPAA and privacy policies.

3. Composes, proofreads and edits grievance letters. Ensures that responses to patients’ concerns are clinically accurate and that letters conform to system and regulatory approved letter formats. Ensures letters are written in a timely manner and notifies patients in writing and/or by phone of any delays. Maintains consistency in writing style and is proficient in the mechanics of writing, including spelling, grammar, punctuation, syntax and idiom.

4. Maintains comprehensive complaint database and records; works to promptly resolve complaints utilizing advanced problem-solving skills and ensures compliance with established authority guidelines; prepares and maintains related letters, reports, documents, and/or other related correspondence.

5. Identifies and helps recognize employees for best practices in delivering an ideal experience and providing timely resolution. Identifies best practices for complaint resolution across the system and recommends policy and process improvements accordingly

6. Assists in informing, educating, and training staff on issue avoidance, resolution timing, recording tool, patient rights, system policies, customer service practices, and/or other applicable items that impact the patient experience.

7. Will serve as initial point of contact for any patient relations issues when patient/family member is not physically present at an entity. Responds in a compassionate manner and improves the overall patient experience by this encounter through effective communication that conveys caring.

8. Records all incoming concerns/complaints into the record system. Ensure all data is collected to assist in the completion of investigative findings and patient/family callback information. Assists teammates with entering cases in a timely manner and answering incoming calls. Will serve as point of contact for regulatory investigation and present data at facility Leadership and quality meetings.

9. This position is responsible for working across multiple entities across staff at all levels to drive an exceptional experience with problem resolution completed in a timely manner. This position will also require medical knowledge as reviewing patient records will be required. This role is responsible for maintaining a balance between established parameters and a positive patient experience. Responsible for system accountability for specific activities surrounding patient satisfaction. Internal customers range from executive staff to point of service providers and staff. External customers are patients, family members, medical staff, payers, and the community-at-large.



MINIMUM QUALIFICATIONS
Bachelor's degree in Nursing (BSN) from an accredited institution (degree will be verified) and/or the equivalent of education and experience combined.

Current RN licensure in the state of practice required. Must obtain CPHRM certification within 2 years of hire.

Three to five years’ of clinical nursing experience; or three to five years’ as a Customer/Patient Relations Representative; or three to five years’ working in Clinical Quality Assurance, Risk Management or Regulatory areas; required. Relates throughout the interview process the experience, training and education needed to perform the job. Demonstrates strong knowledge of medical terminology and a robust understanding of medical practices. Must have excellent oral, written and interpersonal communication skills to effectively interact and provide assistance to a diverse group of stakeholders.

Must have excellent working knowledge of personal software packages such as Microsoft Office. Must have the ability to organize, prioritize and multi-task workload in a fast paced environment. Excellent use of written language in composing a variety of presentations, policies, procedures, and other applicable communication pieces. Skilled in solving problems in order to facilitate the communication network between patient and hospital. Skilled in maintaining composure and professional demeanor in difficult and stressful situations. Requires a passion for providing excellent customer service, collaboration, and continuous improvement.

PREFERRED QUALIFICATIONS
At least two years’ experience in customer service field in a medical environment preferred. Bilingual skills may be a plus.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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