Patient Advocate Specialist - 40 Hours

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Location: Winchester, MA
Job ID: 175384-1A
Date Posted: Jun 8, 2022
Category: Specialist

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Job Description

Welcome To

Welcome to Winchester Hospital, part of Beth Israel Lahey Health. Winchester Hospital was the first hospital in Massachusetts to earn Magnet recognition, the American Nurses Association’s highest honor for nursing excellence, three times. It has since received the recognition a fourth time. As the northwest suburban Boston area’s leading provider of comprehensive health care services, the 229-bed facility provides care in general, bariatric and vascular surgery, orthopedics, pediatrics, cardiology, pulmonary medicine, oncology, gastroenterology, rehabilitation, radiation oncology, pain management, obstetrics/gynecology and a Level IIB Special Care Nursery.

 

About the Job

JOB SUMMARY:         

Contributes to the Hospital’s mission by collaborating with stakeholders throughout the hospital including patients, family members and visitors to address and work toward preventing patient and visitor complaints and concerns. This position will have an impact on the patient/visitor experience by addressing complaints timely and empathetically and on finances and quality/safety by identifying and addressing trends, conducting root cause analysis, and collaborating throughout the hospital to build a culture committed to improving the patient experience, reducing organizational risks and increasing comprehensive reporting.

 

QUALIFICATIONS:

Education

Preferred:  Registered Nurse with a Bachelor’s degree or a Candidate with strong Clinical experience in a similar role. 

Experience

  • Two (2) years of experience in a full time capacity resolving complex customer complaints and/or managing organizational risk

            OR

 

  • Five (5) years of experience as an RN or Attorney with demonstrated ability to de-escalate problems and resolve conflicts. 

Preferred:

  • Experience in a hospital setting
  • Medical terminology
  • Meditech and/or Epic knowldege
  • Other Skills/Knowledge

Required:

  • Excellent communication and customer service skills.
  • Computer experience and comfort with learning new data bases.
  • Strong organizational skills.
  • Strong ability to work collaboratively with other members of the health care team.
  • Strong knowledge of Excel, Microsoft Word.    
  • High level of critical thinking skills. 
  • Ability to triage priorities and problem solve in a variety of situations.
  • For safety and quality reasons, must be able to read, write and communicate. effectively in English with patients, visitors and fellow members of the hospital team.

 

 

LICENSES, REGISTRATIONS, CERTIFICATIONS:  Massachusetts license as a Registered Nurse or Member of the Massachusetts Bar Association

LIFE SUPPORT CERTIFICATION REQUIRED:  N/A

 POPULATION SPECIFIC REQUIREMENTS:  N/A

 

OTHER JOB REQUIREMENTS:

Professional Commitment Requirements:  Keep abreast of developments in the field and/or licensure through continuing education, participation in professional organizations or a combination of both.

On-call Requirement:   Based on business needs

Schedule Requirements:  Generally business hours; however schedule may vary based on business needs.

Travel Requirements:   Within the organization and the local community including, on occasion, other LHS sites.

 

REPORTING RELATIONSHIPS:

  • Reports to the Director of Guest Services
  • Not responsible for supervising the work of others.
  • Able to influence behavioral changes in others without any reporting relationship (matrix structure)

 

As part of the Guest Services team, this position serves a tri-role:

 

Tracking and Addressing Complaint/Risk Related  Issues:

 

  • With minimal direction from the Director of Guest Services and the Risk Manager:
  • Receives and data inputs grievances and complaints through the designed database system, inputting comprehensive and accurate incident reports to thoroughly understand the issues. 

 

  • Investigates as necessary. 
    • Complaints/grievances are varied, including but not limited to lost or damaged property, as outlined in the hospital policy.
    • Collaborates extensively with Patient Financial Services regarding billing related complaints. 

 

  • Triages and dissects issues.  Keeps key stakeholders informed, if appropriate.
    •  Properly assesses and communicates urgency.
    • Understands the CMS regulations regarding complaints.  Properly conveys deadline requirements and holds stakeholders accountable for meeting those deadlines.

 

  • Follows up and/or initiates appropriate interdepartmental communication and ensures timely and accurate documentation of all interdepartmental follow-up of grievances and complaints by leaders assigned for follow-up. Establishes timeframes and tracks timeliness of responses.  Ensures accurate and comprehensive documentation is submitted.

 

  • Tracks status of issues and follows up to ensure closure.

 

  • Generates a variety of reports on a monthly basis and provides a semi-annual and annual summary of grievances with the appropriate corrective action plans.  Highlights concerning trends and/or anomalies.

 

  • Provides data and information for the OPPE review process.

 

  • Escalates all potentially compensable grievances to the Risk Manager.  Informs manager of issues and trends.  Collaborates to determine appropriate course of action in the best interest of all parties while protecting the organization's assets.  Implements approved plan as directed.

 

  • Meets with patients and families as needed to advocate on and attempts to resolve issues identified. 

 

  • Explains policies and procedures to patients and refers them to proper services.  Actively participates in problem solving and resolution of patient complaints and grievances.
  • Communicates patient and visitor rights and responsibilities in an empathetic yet professional manner to encourage ownership of responsibilities.
  • Accurately conveys policies, applicable laws and regulations, billing and health insurance procedures and organizational structures.  Researches applicable departmental procedures before communicating with patients/visitors.
  • Negotiates within designated authority level.

 

Participating in/leading Performance Initiatives to Reduce Complaints and Risk Related Issues:

 

  • Conducts root-cause analysis to thoroughly understand contributing factors into customer complaints.   Collaborates with Risk Management to ensure resources are appropriately allocated and utilized, based on skill sets and the issues.

 

  • Utilizing root cause analysis techniques and best practice customer service techniques, works with leaders to improve system issues that cause repeat complaints and issues.

 

  • Serves as a member of the Patient Family Advisory Committee.

 

  • Meets with Service Response Center to identify correlations concerning response center tickets and patient complaints and grievances.  Makes recommendations to Director of Guest Services and as directed shares with key stakeholders. 

 

  • As assigned, leads hospital-wide or area/issue specific projects designed to improve patient/family member experiences and reduce risk.

 

  • Networks with others in the Lahey Health System responsible for complaint management to identify trends across the organizations and identify, create, and/or share best practices.  Provide inter-hospital support and guidance as needed.

 

 

Mentors and trains staff and leaders to improve customer service and patient/family member interactions.

 

  • Regularly rounds in all clinical and patient care areas meeting with patients, families and staff. As indicated, initiates service recovery.

 

  • Is visible to staff, modeling PROMISE behaviors and concern resolution processes.  Coaches, mentors and supports staff to improve PROMISE behaviors and staff's abilities to de-escalate issues and resolve issues. 

 

  • Provides performance feedback on staff directly to the staff member thus fostering a culture of continuous learning and improvement.  Escalates to the manager/supervisor as appropriate.  Addresses staff safety concerns promptly. Provides input to Human Resources and/or management when appropriate.

 

  • Provides real time consultative services to collaborate with employees, supervisors and physicians who see a problem developing to offer suggestions and best practices to resolve issues

 

  • Develops and runs customer service related training.  Develops education materials and other mediums to properly convey policies, procedures, and the organizations expectation.  Training may include train the trainer.  Is able to adjust training techniques and programs to properly educate to all levels in the organization. 

 

  • Educates staff, physicians and vendors on patient and visitor rights and responsibility to patients, family members and staff.  Coaches and mentors hospital associates regarding their responsibilities, policies, procedures, performance standard expectations.  Councils associates on their rights as well.

 

  • Provides formal training on related topics to improve the organizations' customer service, ability to react properly to conflict and to reduce customer/visitor complaints and grievances.

Shift

Hours: 40 Hours Weekly

About Us

Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve.  Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.  Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.

Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.