Patient Grievance & Relations Specialist; Clinical

As a Patient Relations Specialist, you will be directly working in a system wide capacity that will heavily rely on your clinical experience and knowledge in support of our patients and their families. Our team is dedicated to actively listening to feedback and advocating for our patients the same way we would advocate for our own families. We serve as subject matter experts in support of our health system at all levels with navigating opportunities shared with us by our patients or their families.

This is a unique opportunity to make a positive difference while working closely in collaboration with multidisciplinary teams to maintain regulatory compliance supporting patient rights.

The Patient Relations Specialist II provides support for all components of the system-wide patient and visitor quality and experience program by incorporating high reliability principles into daily work that drives an effective patient relations program. Assists leadership and coworkers on the Patient Relations team to support Department of Patient Experience efforts system wide. Serves as a subject matter expert with service recovery, documentation, investigation, and resolution of patient and visitor complaints system wide.

Actively participates in the pursuit and accomplishment of department goals and initiatives to ensure regulatory compliance is met regarding the timely and effective response to patient and visitor complaints and grievances with OU Health. Advocates for and nurtures a system-wide culture of safety for patients, workforce members, providers, and visitors through direct interactions.

• Supports the daily operations of the Patient Relations team, including fielding patient and visitor complaints received in all modalities.
• Reviews daily files submitted into Patient Relations software for complaints needing attention or review by the Patient Relations team.
• Analyzes files not submitted by the Patient Relations team to determine if a submitted file should be escalated to a grievance from a complaint and initiates actions as appropriate.
• Provides service recovery and de-escalation techniques to assist complainants navigate their right to file a complaint with our health system.
• Maintains a team approach to support compliance with regulatory guidelines and timelines as outlined by policy with the timeliness of acknowledgement and resolution letters for patient grievances.
• Composes and mails letters to patients or their representatives including grievance acknowledgements, grievance resolution, valuables reimbursement, and other written communications as needed.
• Inputs data into Patient Relations software to ensure accurate data on trends of feedback received.
• Communicates effectively with leadership to support the identification of areas requiring additional focus by monitoring active trends based on locations, volume, types of concerns communicated, and effectiveness of responses to complaints input into the software.
• Conducts and guides investigations into grievances including guidance to unit leadership, interviewing personnel involved, chart reviews, and hold debriefing sessions as needed.
• Conducts reviews of concerns and determines if additional escalations are required from the complaint including but not limited to the Department of Patient Safety and Regulatory, Ethics and Compliance referral, Human Resources referrals, and service line executive leadership referrals.
• Appropriately follows policy for escalating allegations of abuse, assault, and neglect to applicable stakeholders or law enforcement as needed.
• Maintains a working relationship with Legal and Claims services to manage risk around complaints and grievances.
• Works collaboratively with all levels of system-wide stakeholders to resolve and report out complaints and grievances.
• Serve on committees as needed as a subject matter expert.
• Participate on teams providing recommendations regarding billing adjustments based on working knowledge of specific cases and patient experiences identified in these cases.
• May be called to support Patient Relations leadership with the preparation, running, and scribing of the OU Health Complaints and Grievances Committee.
• Advocates for patients and visitors' requests for assistance or concerns through effective communication with all appropriate levels of OU Health personnel in an impacted area or…