Patient Relations Specialist - Massachusetts

Optum; Worcester (MA); Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Job summary

Optum is seeking a Patient Relations Specialist in Massachusetts to manage escalated patient complaints and provide guidance across the organization. The role supports quality and service initiatives and coordinates with senior leadership to improve patient care.

You will handle investigations, train managers, and use our reporting systems to ensure timely responses while collaborating with Risk and Quality Management on policy adherence and organizational learning.

Qualifications

• 5+ years in member/guest/patient customer service within healthcare.
• Experience with electronic tools and applications (phone, keyboard, computer apps).
• Excellent writing and speaking skills with the ability to respond promptly and effectively to complaints.

Responsibilities

• Serve as organizational resource for handling difficult patient issues and provide coaching and guidance.
• Evaluate potential actions to resolve complex matters and present recommendations.
• Coordinate investigation of complaints from patients and regulatory agencies; ensure prompt investigation and response.
• Utilize resources to address patient concerns and train managers on filing processes.
• Capture, update, and close patient concerns using the reporting system and communicate status to patients.
• Collaborate with leadership to raise staff awareness on handling complaints and participate in quality initiatives.
• Review quality concerns with Risk and Quality Management to ensure policy adherence.
• Analyze patient feedback data and present improvement recommendations to service leaders.
• Communicate best practices across the organization to raise standards in patient care.
• Perform other duties as assigned.

Skills

Healthcare CS

Written & verbal comms

Computer skills

Tools

Epic

RL Datix

Job description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Position in this function is under general supervision of the Senior Manager, The Patient Relations Specialist, serves as organizational experts for escalated patient complaints directed to corporate patient relations, The Office of the President, payers, social media, outside healthcare organizations, and regulatory agencies for Optum Massachusetts. Provides organization-wide guidance and support for the handling of complex and difficult patient issues. Assists organizational initiatives related to improving and enhancing quality of care and service for patients. Serves as a primary organizational resource to internal and external constituents on all matters related to patient relations and service excellence. Assist with the coordination of various organizational quality and service-related programs.

If you are located in Massachusetts you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities

• Serves as an organizational resource for service line leadership regarding the handling of difficult, complex, and/or sensitive patient issues. Provides coaching, support, and guidance on the handling of difficult patient issues
• Independently evaluates potential courses of action needed to achieve a suitable resolution to complex or sensitive matters and presents recommendations as appropriate
• Coordinates the investigation of complaints presented by patients and/or regulatory agencies. Intakes feedback and complaints on the CEO and CMO's behalf and coordinates their prompt investigation, resolution, and response
• Utilizes initiative, creativity, and available resources to address patient concerns
• Serves as an organizational resource for system-related inquires and provides training as needed to file managers. Utilizes the patient relations reporting system to capture, update, and close patient concerns and ensures a timely response to patients regarding status or outcome of the concern resolution
• Collaborates with service line leadership, Risk and Quality Management on the handling difficult patients. Assists on developing educational programs to raise staff awareness to handling patient complaints
• Reviews quality of care concerns with Risk and Quality Management to ensures adherence to applicable policies and procedures
• Reviews patient feedback data and presents recommendations to service line leadership for improvement initiatives
• Collaborates with leadership in communicating and transferring best practices and lessons learned across the organization through written communications and meetings to raise standards for handling patient complaints
• Performs other duties as assigned

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• 5+ years of experience in member/guest/patient customer service within the healthcare industry
• Experience using electronic tools and applications relevant to the performance of the duties of the position, including but not limited to phone, keyboard, computer and computer applications
• Proven excellent writing and speaking skills with proven ability to effectively respond promptly and effectively to complaints both verbally and in writing
• Proven solid organizational skills, good judgment and attention to detail
• Primary residence in the state of Massachusetts

Preferred Qualifications

• Experience managing patient issues and feedback
• Experience investigating complaints presented by patients and/or regulatory agencies and coordinating resolution and response
• Epic experience or other EMR system
• Experience working with RL Datix or other safety event reporting systems
• Team Lead or Supervisory experience
• Experience with Lean/Six Sigma tools and methodologies
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

In addition to your salary, we offer benefits such as,

• a comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.