Grievance Specialist

SHIFT:

Day (United States of America)

Seeking Breakthrough Makers 
 
Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation. 
 

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career. 
 
CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means. 

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 profess