Job Description
Overview:
Be inspired. Be rewarded. Belong. At Emory Healthcare.
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
Comprehensive health benefits that start day 1
Student Loan Repayment Assistance & Reimbursement Programs
Family-focused benefits
Wellness incentives
Ongoing mentorship, development, and leadership programs
And more
Work Location: Atlanta, GA
Description:
RESPONSIBILITIES:
Patient Advocate 2 manages the investigation, management, regulatory compliance and resolution of complaints and grievances
Collaborates with team members across the system and external resources to support service facilitation requests on behalf of patients, families, leadership, physicians and staff
In compliance with regulatory guidelines, resolves quality of service and quality of care complaints and grievances on behalf of Emory Healthcare
Firmly adheres to federal regulations and Emory Healthcare policies related to the rights and responsibilities of the patient and their representatives, including HIPAA, non-discrimination policies and workplace violence
Patient Advocate 2 serves in advisory role to share the voice of the patient, identify barriers to service, regulatory compliance and support patient experience strategy
Reports to Patient Experience Director
In addition to the core skills and requirements of Patient Advocate 1, investigates complaints and grievances and collaborates on issue clarification, chart review, policy and procedure review and interviewing
Responsible for timely intake, prioritization and delegation of patient complaints, grievances and service facilitation requests
Complies with all regulatory requirements and EHC policy governing patient complaints and grievances including 7/30 day written responses to patients and documentation in event management systems
Responsible for getting resolution for complex cases in collaboration with leadership and stakeholders
Leads creation, reviews and timely distribution of reports for Grievance Review Committee, Joint Commission surveys and state regulatory agency visits in compliance with EHC policy
Adeptly creates and analyzes reports from Risk Management documentation system for trends and improvement opportunities
Collaborates with Patient Financial Services on billing complaints as needed. - Rounds in clinical areas and provides real time coaching
Prepares and presents patient advocacy training classes including new employee orientation
Responds to inquiries from insurance companies regarding quality of care and service concerns raised by members and ensures resolution, follow up and documentation as needed
Responsible for timely, accurate, and thorough documentation of investigations and resolutions in the event management system
Demonstrates leadership skills in committees and improvement projects to improve patient experience
Performs daily rounds in designated areas and partners with clinical teams to address questions, concerns and resolution of requests and performs routine rounds of common areas and reports facility and safety issues needing attention
Manages complex cases with interdisciplinary teams and responds to cases that are escalated to senior leaders
Successfully engages with multiple levels of leadership to assesses case consequences, makes recommendations based on investigation and advises on timely resolution for complaints and grievances
Works with risk management, quality department, social services, chaplaincy, physicians, public safety, executive administration and financial services on appropriate written and verbal responses to patient grievances
Convenes and facilitates multi-disciplinary groups and arranges family meetings as needed for resolution of complaints and grievances
Works closely with risk managers to identify and investigate matters that have the potential to become a claim or a lawsuit
Manages the formal grievance process according to CMS rules, Joint Commission and EHC policy
Serves as a resource to patients, families, and staff for interpretation of Patient Rights and Responsibilities, including HIPAA and Non-discrimination policies
Advises on content for patient-facing communications to improve patient experience
Designs and determines appropriate service recovery gestures including decisions relating to monetary compensation and reimbursement
Assists with recovery and resolution of lost belongings
Triage incoming concerns and requests: email, phone, in-person
Delegates and assigns cases to leaders for follow up and resolution
Works with manager to formulate plan for personal professional development and identify needed resources for training
Attends meetings, huddles and educational in-services as appropriate
Actively participates in improvement projects that improve workflows, efficiency, accuracy, and quality of care experience
Participates in professional activities and organizations to maintain knowledge of current trends, practices, and developments
Cross-trains with other divisions and flexes time as needed to support Patient Relations coverage for other operating units
Performs other duties as assigned
SKILLS REQUIRED:
Demonstrates expertise in navigating complex patient care situations
Comprehend and interpret EHC policies impacting safety and customer service
High degree of interpersonal communication and relationship building skills
Demonstrated proficiency in computer programs such as customer databases, Microsoft Office and electronic medical record systems
Ability to work independently
Conflict management
Highly organized and ability to prioritize multiple tasks and case load
Local travel may be required
MINIMUM EXPERIENCE:
3-5 years experience of customer service or case management experience
Healthcare experience working with clinical teams and/or patients preferred
Demonstrated conflict management and problem solving skills
Telecommunication skills and proficiency using multi-line phone and cell phone
MINIMUM EDUCATION:
Bachelor's Degree in healthcare preferred
Associate degree or case management / customer service experience
Any combination of education and experience considered
PHYSICAL REQUIREMENTS:
Frequent standing & walking (50% of the workday)
Occasional sitting (50% of the workday)
Carrying of objects up to 10 lbs
Close eye work (computers, typing, reading, writing)
Physical demands may vary depending on assigned work area and work tasks
Additional Details:
Supporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and/or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.
ACCOMMODATIONS: EHC will provide reasonable accommodation to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”
PHYSICAL REQUIREMENTS: (Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.
Job Tags
Full time, Local area, Outdoor, Flexible hours, Shift work,