Patient Advocate

Carilion Medical Center; Roanoke (VA); On-site; USD 38,000 - 52,000; Full time

Job summary

Carilion Clinic is seeking a Patient Advocate to provide frontline management of complaints and grievances from patients, families and visitors. You will investigate, document, and determine the appropriate disposition, escalating when needed, while coordinating with staff and risk management teams.

You will play a key role in educating staff about patient advocacy, supporting service recovery initiatives, and helping patients navigate the healthcare system across clinical sites.

Qualifications

• Education: High school diploma or GED required.
• Experience: 1 year in patient care or customer service; 5 years in Service Recovery or Dispute Resolution, 3,000 hours, or 50 percent of full-time duties.

Responsibilities

• Handles frontline intake, investigation, and resolution or escalation of patient, family, and visitor complaints.
• Acts as liaison between staff and patients/families and coordinates with Clinical Risk teams.
• Maintains thorough documentation of issues, actions taken, and outcomes for compliance review.
• Educates staff about the Department of Patient Advocacy and supports service recovery efforts.
• Collaborates with healthcare teams and regulatory bodies to help patients navigate care.

Skills

Communication skills

De-escalation

Conflict resolution

Documentation

Liaison

Investigation

Education

Staff collaboration

Education

High school diploma or GED

Tools

Rounding tool

Job description

Employment Status: Full time Shift: Day (United States of America) Facility: 1906 Belleview Ave SE - Roanoke Requisition Number: R163093 Patient Advocate (Open)

How You'll Help Transform Healthcare:

The Patient Advocate provides frontline risk management through the intake, investigation, and either resolution or escalation of complaints and grievances from patients, family members, and visitors. The Patient Advocate will exercise autonomy in determining the optimum method of management to ensure the best possible outcome for all involved. The Patient Advocate will provide support to Carilion Clinic staff by assisting with communication between staff and patients and families and acting as liaison when appropriate.

The Patient Advocate

• Applies communication skills, de-escalation techniques, and resolution strategies to the management of patient, family, and visitor complaints and grievances.
• Receives and process calls, letters, visits or other notifications of complaints. Reports potential claims to the Manager of Patient Advocacy as needed.
• Maintains thorough and precise documentation for future reference that is inclusivie of identified issues and resolution/action taken in accordance with compliance of regulatory agencies.
• Serves as patient liason for Treatment Appropriateness Review Committee (TARC) and Syncronized Ongoing Support (SOS) complex cases that requires significant management.
• Investigates complaints by actively working with managers/directors of affected areas to determine issues. This includes talking with care givers or other staff involved in the care of the patient. Determines the location of the event incident, requesting medical records, obtaining release from patient for access to medical records from outside facilities, when necessary. Meets with patients, families or involved persons and investigates complaints and concerns.
• Determine completeness of complaint response and forwards the information to Clinical Risk team for final review.
• Following the investigation of a complaint/grievance determines the appropriate disposition for that complaint /grievance (resolution, escalation, or response and closure). Works with appropriate internal and external resources to effectuate disposition as necessary. Works within the parameters established by departmental policy.
• Proactively provides education and support to patients, families, visitors, providers, and staff through regular rounding in clinical areas and practice sites. Educates and orients staff regarding the Department of Patient Advocacy and provides other educational opportunities as appropriate.
• Works collaboratively with other members of the healthcare team, regulatory agencies, and third party organizations to help patients & families navigate the healthcare system.
• Provides accurate and up-to-date complaint and grievance information to the Director on a monthly basis for incorporation into report to Grievance Committee. Reports on directly to the Grievance Committee regarding specific issues or initiatives on an "as needed" basis.
• Personally escorts patients, employees or families as indicated to the appropriate locations. Provides support to Guest Services as appropriate.
• Acts as patient liason in service recovery efforts systemwide to include ambulatory sites and community hospitals. Partners with Quality Directors at community hospitals for resolution of patient complaints and grievances.
• Stay informed of proposed regulatory and/or process changes in a timely and accurate manner.

This position will provide frontline management through the intake, investigation, and either resolution or escalation of complaints and grievances from patients, family members, and visitors. The Patient Advocate will exercise autonomy in determining the optimum method of management to ensure the best possible outcome for all involved. The Patient Advocate will also provide support to Carilion Clinic staff by assisting with communication between staff and patients and families and acting as liaison when appropriate.

Receives and process calls, visits or other notifications of complaints. Reports potential claims to the Director of Patient Advocacy as needed.

Investigates complaints by actively working with managers/directors of affected areas to determine issues. This includes talking with care givers or other staff involved in the care of the patient. Meets with patients, families or involved persons and investigates complaints and concerns.

Uses rounding tool to document feedback from patient, visitors, and families

Proactively provides education and support to patients, families, visitors, providers, and staff through regular rounding in clinical areas and practice sites.

What We Require:

Education: High school diploma or GED required.

Experience: 1 year of experience in a patient care or customer service area required. 5 years of experience in Service Recovery or Dispute Resolution, 3,000 hours, or 50 percent of full-time job duties withi