Patient Advocate - Conflict Resolution (Clackamas, OR) (
Job Number: 539928 )
At Kaiser Permanente Northwest, the work you do every day supports the health of our members. That's because each of us-from our financial, business, and IT experts, to our RNs, allied health professionals, and physicians-shares a commitment to providing the best possible care experience. Widely regarded as a mecca for outdoor enthusiasts, the Pacific Northwest blends urban bustle with open space in a way that is sure to enhance your own state of well-being. Looking to build a rewarding career in an environment that supports your success? Join us and put your beliefs into practice.
Description
Decrease hospital complaints and increase patient and family satisfaction by working directly with patients and families, in collaboration with hospital clinicians and administration, to address concerns regarding care and service as rapidly and effectively as possible. Decrease formally filed complaints, liability, and adverse media by effectively resolving complaints in the moment within federal/state/contractual/joint commission laws/regulations, policy, and legal principles. Advises clinician, staff, and administrators on working with difficult customers to develop processes to avoid customer dissatisfaction.
Essential Responsibilities:
Directly intervene in patient and family concerns regarding hospital care and service to address concerns in a timely and appropriate manner. Offers escalated level of response in coordination with HAS involvement. Reduce formally filed complaints to Member Services/Member Relations, and improve customer satisfaction scores across the hospital. Ensure regulatory requirements are met for complaints.
Organize and facilitate care conferences for patients with difficult care issues and/or dissatisfaction with care/services. Develop, write care plans that address concerns. Help create and write behavior contracts with a patient-centered focus to enhance patient understand of behavioral expectations and its relation to service outcomes.
Communicate to, educate, and coach KSMC staff, administrators, and clinicians about ways to improve patients' care experience through various methods including but not limited to department staff meetings, management meetings, and hospital communications, based on patient complaint data and case by case experiences. Works with regional Care Experience team to guide organizational efforts to improve patient satisfaction with their care.
Advise and direct interventions of KSMC administrators and physicians when dealing with difficult, sensitive, and high risk member/patient or group situations to promote member and group satisfaction and retention. Reduce potential hospital and/or plan liability by ensuring compliance with explicit and implicit contractual obligations and federal/state government laws/regulations. Support plan and affiliated providers/managers/staff when dealing with members who demonstrate inappropriate, abusive, intimidating or physically violent behaviors; issue conversation/letters on behavioral expectation, develop behavioral contracts or case management protocols. Document events in CIDARS and consult as needed with Member Relations/Health Plan.
Liaison between KSMC and Member Relations to organize collaborative responses across various hospital departments to fully address formal patient complaints within regulatory timelines.
Qualifications
Basic Qualifications:
Experience
Minimum two (2) years of experience working directly with customers in a service, marketing, risk management, or health care related role involving service recovery and/or conflict resolution.
Minimum two (2) years of experience in a health care related field.
Minimum one (1) year of experience in the Kaiser Permanente Organization.
Education
Bachelor's degree.
License, Certification, Registration
NA
Additional Requirements:
Basic knowledge of medical terminology.
Basic knowledge of clinical services, policies, and procedures.
Excellent oral communication skills; demonstrated ability to negotiate in highly charged emotional situations, defuse anger and resolve conflicts both in person and over the telephone by utilizing a variety of mediation, conflict resolution, and negotiation methods.
Excellent writing skills; demonstrated ability to summarize complex and sensitive information, and write reports/memos/letters in a clear, concise, non-judgmental, non-threatening and effective manner.
Excellent judgment, analytical and problem-solving skills; demonstrated ability to interpret complex medical and interpersonal information, identify important issues, assess completeness or adequacy of information, make independent decisions under a frame work of general policy and develop effective recommendations and resolutions.
Strong ability to collect and interpret data for process improvement.
Excellent time management/prioritization skills; demonstrated ability to handle multiple tasks, with shifting priorities, successfully meeting deadlines with a high volume of work.
Positive attitude toward health care as a service industry.
Work well within a team of diverse people.
Demonstrated ability to use Microsoft Word and PowerPoint, and additional hospital software.
Demonstrated experience and comfort providing effective, positively received presentations to groups of up to 50 people.
Demonstrated cultural competence and appreciation of the different needs of different groups/individuals as they interact with hospitals.
Preferred Qualifications:
Four (4) or more years of experience working in a health care environment working directly with customers; e.g. patients, family/support members, front line staff, administrators, clinicians, etc.
One (1) or more years of experience with health care Compliance provisions as they relate to patient complaints and care.
Experience interacting with various Kaiser Permanente areas (e.g. PFS, Risk Management, Member Services, Member Relations, Claims Administration, Medicare, Medicaid, etc.).
Master's degree in social work, psychology, conflict resolution, or related field.
Background in mental health or degree related to mental health.
Intermediate/competent knowledge of internal computer systems including Lotus Notes/Health Connect/Common Membership/ MS Office/Resolute.
Basic knowledge of federal and state regulations pertaining to grievances and provision of care/services.
Primary Location : Oregon-Clackamas-Kaiser Sunnyside Medical Center 10180 SE Sunnyside
Scheduled Hours (1-40) : 40
Shift : Day
Working Days : Mon-Fri
Working Hours Start : 8:00 AM
Working Hours End : 5:00 PM
Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group (Union Affiliation) : Salaried, Non-Union, Exempt
Job Level : Individual Contributor
Job : Customer Services
Public Department Name : Service and Care Experience
Travel : Yes, 25 % of the Time
Job Eligible for Benefits : Yes
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
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