Grievance Specialist

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A Brief Overview
The Grievance Specialist is an institutional expert assessing the management and disposition of written correspondence to and from patients and families in accordance with critical regulatory laws, rules, regulations (CMS, JCAHO, and DOH.) The Grievance Specialist will be responsible for guiding and coordinating the overall grievance process for responding to and resolving all verbal and written complaints and grievances from patients and families related to their concerns. The Grievance Specialist will work with patients, families and clinical and operational teams and local leaders to address complaints or special needs that may arise during the course of treatment within the hospital setting. The Grievance Specialist will work directly with various members of the healthcare team, hospital departments, and administration to solve problems that patients and families may have with the goal of facilitating a positive patient experience during their time in the Enterprise. The Grievance specialist may act as an intermediary between hospital departments and the patient and family to bring about the most effective healthcare treatment and positive hospital experience. The grievance specialist will partner and collaborate with local leaders to successfully address patients and families' grievances and complaints by identifying factors necessary for the optimal resolution of complaints and incorporating into written correspondence to patients and families. The Grievance Specialist will provide assistance and oversight and education to local leaders in responding to patient/family complaints and grievances.

Under the direction of the Manager of the Office of Feedback, the grievance specialist will be responsible for maintaining highly sensitive materials and data that is essential for Hospital compliance with regulatory requirements. The position is responsible for maintaining the privacy and confidentiality of information, acting with ethics and integrity, reporting noncompliance, adhering to company policy and procedures, including accreditation requirements, applicable federal, state and local laws and regulations.

What you will do

• Clinical Excellence: (50%)
• Interprets CMS, JCAHO, DOH laws, regulations, rules, for management of written correspondence to patients/families. Will carry an active grievance caseload and is also responsible for ensuring prompt resolution of patient complaints/grievances.
• Maintain working relationships with local leaders throughout the CHOP system and serves as an advisor and support in investigating and responding to patient/family complaints. Provides expert advice to local leaders, physicians and executives on information and interpretation of the organization's grievance policies, procedures and guidelines when the issues presented require substantial interpretation.
• Uses good judgment to identify all issues and required actions to successfully resolve and respond to incoming complaints. Prepares written responses as appropriate in the resolution of grievances.
• Informs management of regulatory and other requirements to be considered when corresponding, and resolving grievances. Collaborates with leaders in Regulatory, Legal, and Risk Management to ensure compliance with applicable laws and regulations.
• Participates in meetings to review incoming complaints and provide accountability for the disposition of closed complaints and grievances.
• Maintains confidential records; enters information into appropriate databases in a timely manner. Provides on-going review and work with identified staff and key stakeholders to ensure appropriate follow-up to any outstanding concerns are addressed and provide ongoing assistance for assigned areas.
• Program Development: (10%)
• Consults on the development of departmental standards and role models professional behaviors that promote collaborative relationships with local and executive leaders.
• Represents and provides the family-center care perspective on hospital-wide committees.
• Conducts departmental and organizational in-services for new staff, and/or hospital staff.
• Participates in the review, revision, and development of Policies & Procedures to reflect hospital and professional practice standards for handling complaints and grievances.
• Quality/Process Improvement: (40%)
• Partners with department leadership team to execute plans to improve patient/family experiences which includes identifying trends and establishing systems to improve.
• Performs rounding on patients and families in the hospital setting to solicit feedback about their hospital experience and forwards any clinical questions to the appropriate leader for follow-up
• Establishes a rapport with the patient and family to learn what is the most important to them in their hospital experience and preferences. Communicates findings to the appropriate healthcare team member
• Responds to and investigates complaints and concerns and communicates identified issues to appropriate staff/ leadership
• Achieves department/organizational outcomes
• Interacts with patients/families and utilizes feedback to improve and reinforce satisfaction and resolution of complaints
• Uses findings from analysis of trends in complaints to mentor individuals and departments to develop appropriate service action plans.
• With Office of feedback leadership, tracks and trends the sources of complaints and grievances in an effort to make proactive improvements to reduce complaints.
• The Grievance Specialist will work with leaders to translate their unit/service/location specific data into meaningful and actionable data/work plans
• Collects and collates data about feedback encounters and themes, prepares reports, analyzes trends, and reports information to appropriate departments/leaders for action.
• Ensures services meet professional standards and regulatory requirements.

Education Qualifications

• Bachelor's Degree Social Work, Nursing or similar field of study - Required

Experience Qualifications

• At least five (5) years experience in a hospital - Required

Skills and Abilities

• Ability to provide exceptional clinical social work or nursing leadership.
• Ability to identify and define problems, collect data/information, establish facts, and draw valid conclusions.
• Knowledgeable and compliant with all relevant laws, rules, regulations and accreditation standards and requirements.
• Ability to work independently.
• Ability to perform multiple task simultaneously, work under pressure and meet critical deadlines.
• Must possess a high degree of professionalism and business ethics.
• Exceptional writing skills.
• Performs work according to CHOP policies and procedures, professional standards of care, and applicable laws.
• Ability to set goals, prioritize, and achieve results in accordance with the highest standards.
• Communicates with sensitivity and respect.
• Understands and promotes CHOP's mission.
• Ability to prioritize and complete duties in a timely and organized manner.
• Works collaboratively and in a positive manner with others.
• Ability to train and coach staff.
• Ability to demonstrate professional and leadership skills.

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more.

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SALARY RANGE:

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

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At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.