Grievance Coordinator

Coordinates, supervises, and ensures timely resolution of patient grievances in accordance with CMS Guidelines and FH Policy. Collaborates with Performance Improvement, Risk Management, Accreditation, and Regulatory Compliance teams. Incorporates Frederick Health’s mission, vision, core values, and customer service philosophy into job performance and adheres to the FH Compliance Program.

Responsibilities

• Ensures prompt response to grievances from patients and families submitted by telephone, 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 into the Event Reporting System.
• Investigates grievances through 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 and sends it 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 identified during the grievance investigation.
• Manages grievance database and produces reports to demonstrate compliance with regulatory standards.
• Provides written reports summarizing 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 stakeholders, and collaborates to develop action plans to resolve common concerns.
• Sets a positive professional example; serves as a role model and mentor.
• Effectively communicates and collaborates with colleagues, multidisciplinary teams, 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 on needs and areas of waste.
• Answers incoming calls to the Service Excellence Department.
• Sorts, logs, and facilitates return of items turned in to Lost and Found.
• Monitors and promptly responds to emails sent to PatientExperience@frederick.health.
• Performs other duties as assigned.

Requirements

• Able to prioritize multiple demands.
• Excellent customer service skills with demonstrated ability to effectively meet customer expectations.
• Conflict management skills.
• Excellent oral and written communication skills.
• 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.
• Familiarity with MS Office products (Word, Excel, PowerPoint).

Qualifications

• Graduate of an approved Bachelor’s Degree program in Nursing or Health Care Administration with 3-5 years of clinical experience.
• Performance 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 may place stress on muscles and tendons.
  • Awkward Posture: Includes repeated or prolonged reaching, twisting, bending, kneeling, squatting, working overhead, or holding fixed positions.
• Bloodborne Pathogens Exposure Risk: Category B – May have exposure to blood or body fluids.

Schedule

• Regular Office Hours, Monday - Friday.

Benefits

• Comprehensive and affordable benefits package, including:
  • Health, Dental, and Vision insurance (offered the 1st of the month after 30 days of employment for employees working at least 20 hours per week; multiple plans available).
  • Employer-paid Life insurance, Short-Term Income Replacement, and Long-Term Disability for eligible employees.
  • Robust Paid Time Off program for eligible employees.
  • 403B retirement plan with employer match for eligible employees.
  • Free financial planning sessions for all employees.
  • Educational assistance program to support education goals.
  • Employer-paid Employee Assistance Program.

Pay

• Pay is based on experience, skills, and education. Part-time positions are pro-rated based on scheduled hours.
• Pay range: $28.86/hr (minimum) - $41.22/hr (maximum).
• Non-Exempt positions may include shift differential and/or overtime pay, if applicable.