Patient Representative II - CLC Patient Services (Onsite)

University-of-Texas-Medical-Branc; Webster (TX); On-site; USD 60,000 - 90,000; Full time

Job summary

UTMB Health in Texas seeks a Patient Services professional to investigate patient complaints and coordinate resolution efforts across care teams. You will assess cases, review records, and conduct interviews to ensure fair handling of issues.

The role involves assisting patients, families, and staff, handling a large caseload, and initiating improvements across policy, quality and safety domains. Strong communication is essential.

Qualifications

• Bachelor’s degree or equivalent and four (4) years experience in social services, clinical care or clinical operations settings including advising patients or customers of their rights and assisting them with resolution to their issues.

Responsibilities

• Investigate patient complaints and de-escalate potentially volatile patient/family interactions with faculty and staff.
• Complete case investigations including issue clarification, medical record review, policy and procedure review and conducting interviews with patients, families and staff.
• Provide assistance/support to patients, families and staff in contact with the Patient Services Department to achieve satisfactory resolution.
• Strive to achieve resolution of complaints at the most appropriate level within the organizational structure, requiring significant interaction at all levels.
• Manage a large caseload of patient inquiries with extensive follow-up, potentially highly sensitive in nature.
• Prepare formal written responses on behalf of UTMB Health and maintain departmental records to facilitate tracking and accountability.
• Initiate corrective action as appropriate to improve patient experience, including recommendations for policy and procedures, quality/safety improvements, or billing adjustments.
• Communicate effectively with patients, families and staff in written and verbal form.
• Coordinate and participate in patient/staff conferences to develop contracts for challenging and/or non-compliant patients.

Skills

Patient rights knowledge

Conflict resolution

Communication skills

Education

Bachelor's degree or equivalent

4 years experience in social services/clinical care/clinical operations

Job description

Bachelor’s degree or equivalent and four (4) years experience, in social services, clinical care or clinical operations settings including advising patients or customers of their rights and assisting them with resolution to their issues.

Job Description:

To provide excellent patient/family experience by investigating patient/family complaints in allutmbHealth settings which includes, care provided by physicians and other healthcare professionals, potential liability, quality of care, hospital policy and procedure, and extensive conflict resolution with challenging patients and families.

Job Functions:

Investigate patient complaints, mediates complex disputes and de-escalates potentially volatile patient/family interactions with faculty and staff.

Complete case investigations which include issue clarification, medical record review, policy and procedure review and conducting interviews with patients, families and staff

Responsible for providing assistance/support to patients, families and staff that are in contact with the Patient Services Department to satisfactory resolution whenever possible.

Strive to achieve resolution of complaints at the most appropriate level within the organizational structure, which requires significant interaction at all levels.

Manage large caseload of patient inquiries, which require extensive follow-up and may be of a highly sensitive nature.

Achieve resolution of complaint/problem at the most appropriate level within the organizational structure.

Prepares a formal written response on behalf ofutmbHealth and maintains departmental records to facilitate tracking and accountability.

Initiates corrective action as appropriate (both for the individual complaint and at the organizational process level) to improve theutmbHealth patient experience, which includes recommendations forutmbHealth policy and procedures, quality and safety improvement initiatives, billing adjustments, or other final dispositions as indicated.

Communicate effectively and professionally to both patient/families and staff with both written and verbal communication.

Coordinates and participates in patient/staff conferences, as negotiated with the care team, to develop contracts for challenging and/or non-compliant patients.

• Act as a resource regarding interpretation to internal and external customers of patient rights and responsibilities which includes information regarding Advance Directives,DNR,wristbands, etc.

Salary commensuratewith experience

UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.