Patient Relations Specialist

Michigan Medicine; Ann Arbor (MI); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Excellent medical, dental and vision

2:1 retirement match

Job summary

Michigan Medicine seeks a Patient Complaints/Grievances Specialist to collaborate with patients, families, and leadership to investigate, document and resolve concerns about the quality of care and services at Michigan Medicine.

You will collect data, coordinate with departments, assess harm per CMS guidelines, maintain data integrity in PSRS, and help ensure timely, compliant case resolution and continuous improvement.

Qualifications

• Bachelor's degree in social sciences, health care administration, or related field or equivalent experience.
• 3–5 years in health care with customer service and complaint management.
• Excellent written, oral and presentation skills.

Responsibilities

• Collaborate with patients, families, Michigan Medicine leadership, and clinical departments to investigate, document and resolve complaints/grievances.
• Collect data relating to patient complaints.
• Review and triage correspondence and regulate the escalation process.
• Assess harm per CMS guidelines and document outcomes.
• Maintain data integrity in the PSRS for departmental dashboards.
• Provide cross-coverage as needed for vacation coverage and related duties.

Skills

Customer service

Data analysis

Time management

Communication

De-escalation

CMS guidelines

Education

Bachelor's degree in social sciences, health care administration, or related field

Job description

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Responsibilities

Collaborate with patients and families, Michigan Medicine leadership, and clinical and hospital departments to investigate, document and resolve patient complaints/grievances concerning the quality of care and services.

Collect data relating to patient complaints

• Listen compassionately but objectively to patients.
• Serves as a liaison between patients, families and physicians, when concerns need to be addressed. This may include on-site and in-person visits.
• De-escalation of complainants who exhibit behaviors on red behavioral scale.
• Review letters addressed to Michigan Medicine leadership as well as UMMG leadership, Ambulatory Care leadership, handle Post-Acute Care complaints and grievances, web-site comments and complaints, referrals from Administrator on Call and House Managers to objectively identify issues.
• Review comments from patient satisfaction surveys objectively for complaints that require follow-up.
• Review lost property reports from the Michigan Medicine Department of Public Safety objectively for items that require follow-up, maintaining communication with the patient.
• Document complaints in an objective manner in the Patient Safety Reporting System (PRSR) that specifically identify the issues to be resolved per CMS guidelines. Assess the level of harm and document in an objective manner. Tag the reports for triage and notification to departments and providers involved in the complaints. Assure data integrity of reports entered as the data is used by Departmental leaders and Chairs to assess for areas of improvement. Their data entry is also used for the National Vanderbilt program on Professional Conduct.
• Accept and review escalated patient concerns triaged from top Michigan Medicine and UMMG leadership.
• May need to provide cross coverage in PRCR UM Health-Sparrow and UM Health-West for vacation coverage, etc.

Identify appropriate follow-up and corrective action

• Solicit feedback and information from involved individuals regarding the patient's complaints, ensuring the integrity of data across a complex organization.
• Investigate the facts regarding complaints, grievance, and lost property reports.
• Assess all complaints and grievances for physical and emotional harm. Continue to manage cases with physical and emotional harm or triage to the appropriate level of service when applicable.
• Maintaining contact with the complainant per CMS and state guidelines, and as appropriate ensure corporate compliance within internal and external regulatory frameworks.
• Analyze the facts to determine appropriate follow up and corrective action as indicated.
• Document all follow up in an objective manner in the PSRS, ensuring the collection of involved party names and attachment of letters sent back to complainant.
• Maintain integrity of RL data entry that populates and displays for many of our Michigan Medicine dashboards.

Independently resolve patient complaints involving significant departmental and organizational resources

• Collaborate with Michigan Medicine Leadership as well as UMMG leadership across the enterprise to improve processes related to the complaint.
• Act as primary resource or support staff in Ambulatory clinics when dealing with escalated patients and families when Ambulatory leadership is unavailable.
• Collaborate with University of Michigan Insurance and Claims Administration office to submit and resolve lost property events.
• Establish rapport with staff and assist in the preparation of reports regarding any incidents that could result in legal action if not resolved.
• Refer patients and their family members to appropriate services and resources.
• Compose patient correspondence including 7-day acknowledgment and closure letters.
• Manage a case load of unique patient complaints in various stages of investigation, follow-up and resolution, meeting CMS guidelines for Complaint and Grievance handling including all incidents of emotional and non-physical harm.

Facilitate system improvements by identifying opportunities for improvement and involving department/unit leadership to improve process/operations using PDCA model

• Analyze PSRS grievance and complaint data to identify and track trends in patient concerns, highlight areas for improvement upon department request, and maintain visibility and engagement with operational leaders.
• Facilitate and participates in process improvement/lean activities specific to the identified issues in collaboration with Michigan Medicine departments and UMMG departments.
• Participate on institutional committees that are involved in the patient experience.
• Collaborate with departments, units, on-site and off-site clinics, to assist in the development, training, and education of improving processes and service recovery efforts at the point of care. All service recovery to follow guidelines established by Office of General Counsel.
• Employees in this position, typically analyze, compare, and evaluate various courses of action and have the authority to make independent decisions, free from immediate direction, within the scope of their responsibilities.
• Annually participate in and analyze Patient feedback data for presentation to Department Chairs, Division Chiefs and Administrative leaders at the Annual Clinical Risk Rounds.

Required Qualifications

• Bachelor's degree in social sciences, health care administration, or related field is desired, or an equivalent combination of education and experience.
• Considerable knowledge and experience in customer service and complaint management with at least three to five years of experience in a health care setting is required.
• Excellent written, oral and presentation skills are necessary.
• Ability to analyze data for patient safety and malpractice trends and areas of potential improvement.
• Ability to manage multiple competing priorities with on call duties and critical event support.
• Knowledge of University policies, rules, and regulations.

Desired Qualifications

• Demonstrated ability to work independently, to meet deadlines efficiently, to perform multiple tasks simultaneously, and to be highly self-motivated.
• Demonstrated ability to identify problem issues, document, and resolve concerns within established guidelines.
• Excellent interpersonal skills with the ability to exercise discretion in matters of a confidential and sensitive nature.
• Excellent problem-solving and conflict resolution skills, as demonstrated by the ability to work effectively with individuals/teams, and across disciplines.
• Demonstrated knowledge of process improvement and quality management is desired.
• Training in complaint management, mediation, conflict negotiation, data management, interpersonal communication, de-escalation, and crisis intervention is preferred.

Why Join Michigan Medicine?

Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world's most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

What Benefits can you Look Forward to?

• Excellent medical, dental and vision coverage effective on your very first day
• 2:1 Match on retirement savings

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants, including protected veterans and individuals with disabilities.