Grievance Coordinator

Job Summary

The Grievance Coordinator coordinates supervises and ensures timely resolution of patient grievances in accordance with CMS Guidelines and FH Policy. The Coordinator works collaboratively with the Performance Improvement Risk Management Accreditation and Regulatory Compliance teams.

Supports and is responsible for incorporating into job performance the Frederick Health (FH) mission vision core values and customer service philosophy and adheres to the FH Compliance Program including following all regulatory requirements and the FH Standards of Behavior.

Example of Essential Functions:

• Ensures prompt response to grievances from patients and families submitted by telephone call written letter email fax or interview.
• Ensures prompt response to requests for information from the State of Maryland CMS The Joint Commission or other third party companies related to patient/family complaints.
• Efficiently and accurately enters concerns as appropriate into the Event Reporting System.
• Investigates grievances by (but not limited to): literature research medical record review consultation with content experts and interviews with involved staff/providers and patient/family members.
• Processes grievances in accordance with regulations requirements and established time frames set by CMS the State of Maryland and The Joint Commission.
• Develops a written response to each grievance which is then sent to the complainant within the designated timeframe.
• Works with appropriate personnel physicians hospital staff leadership and the patient/family member to facilitate appropriate follow-up and ensure resolution of concerns and complaints.
• Initiates peer review process when indicated.
• Collaborates with Patient Financial Services to make account adjustments as appropriate.
• Coordinates with Risk Manager on any potentially litigious situation that is identified during the course of the grievance investigation.
• Manages grievance database and produces reports to demonstrate compliance with regulatory standards.
• Provides written reports including a summary of activity by the number and type of concerns complaints and grievances received as well as the resolution status of all cases.
• Develops and coordinates the presentation and communication of grievance data to organizational stakeholders.
• Identifies trends in patient concerns and complaints communicates information about trends to organizational stakeholders and collaborates with organizational team members to develop action plans to resolve common concerns.
• Sets a positive professional example for others; serves as a role model and mentor.
• Effectively communicates and collaborates with colleagues multidisciplinary team and customers.
• Is detail-oriented and follows through with projects and requests.
• Takes ownership of problems and displays initiative to resolve issues.
• Achieves results on time by focusing on priorities and managing time efficiently.
• Empowers staff treats others with fairness kindness and respect for personal dignity and privacy.
• Actively participates in cost containment by providing input with needs and areas of waste.
• Answers incoming calls to Service Excellence Department.
• Sorts logs and facilitates return of items turned in to the Lost and Found.
• Monitors and promptly responds to emails sent to the email address.
• Other duties as assigned.

Required Knowledge Skills and Abilities:

• Able to prioritize multiple demands.
• Excellent customer service skills with demonstrated ability to effectively meet customers expectations
• Conflict management skills
• Excellent oral and written communication skills
• Demonstrates effective time management and organizational skills
• Ability to guide and/or facilitate a team and promote positive interactions across departments.
• Experience with cost analysis and patient accounts required.
• Familiar with MS office products to include Word Excel and PowerPoint

Minimum Education Training and Experience Required:

• Graduate of an approved Bachelor Degree program in Nursing or Health Care Administration with 3-5 years of clinical experience.

Patient Contact

Must demonstrate and maintain current knowledge and skills in providing appropriate care/contact for patients in the following age groups:

XPerformance of job does not require patient contact

Physical Demands:

Sedentary - Light Work- Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes).While work is mostly done sitting a certain amount of walking or standing is often necessary.

Ergonomic Risk Factors:

Repetition:Repeating the same motion over and over again places stress on the muscles and tendons.The severity of risk depends on how often the action is repeated the speed of the movement the required force and muscles involved.

Awkward Posture:Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity.Awkward postures include repeated or prolonged reaching twisting bending kneeling squatting working overhead with your hands or arms or holding fixed positions.

Working Conditions:

1. Bloodborne Pathogens Exposure Risk:Category B MAY have exposure to blood or body fluids.
2. Regular Office Hours Monday - Friday

Reporting Relationship:

Reports to Supervisor

Caring for you as you care for the CommUNITY

Frederick Health offers a comprehensive and affordable benefits package. Health Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your familys needs. Life insurance Short-Term Income Replacement and Long-Term Disability are employer paid for eligible employees. Frederick Health offers a robust Paid Time Off program for eligible employees. Our 403B retirement plan helps you save for your retirement and includes an employer match to eligible employees. All employees have access to free financial planning sessions. We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.

Pay is based on experience skills and education. If position is part-time salary will be pro-rated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. Non-Exempt positions may have shift differential and/or Overtime paid if applicable.

Pay range: $28.86/hr Min - $41.22/hr Max

Required Experience:

IC