Patient Risk Relations Specialist

CO01 Southern Illinois Hospital Services Inc.; Carbondale (IL); On-site; USD 69,000 - 107,000; Full time

Job summary

Southern Illinois Healthcare is seeking a Patient Relations and Risk Management professional in Illinois to manage patient grievances and risk events with a focus on transparency and timely resolution.

The role requires nursing licensure in Illinois, an associate degree (bachelor's preferred), and the ability to de‑escalate emotionally charged situations while guiding multidisciplinary teams.

Qualifications

• RN licensure in Illinois required or active license.
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Responsibilities

• Directly handle patient grievances via in-person, written, or electronic communications.
• Investigate concerns with administration, providers, and managers for timely responses.
• Facilitate grievance meetings and act as patient liaison.
• Direct inquiries to appropriate medical staff and ensure satisfactory resolutions.
• Explain policies and services using medical knowledge.
• Assist with billing concerns related to patient grievances under Risk Manager guidance.
• Collaborate across the organization to investigate patient lost belongings and initiate reimbursements where warranted.

Skills

Patient relations

Risk management

De-escalation

Independent work

Communication

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing preferred

Job description

Position Summary

Responsible for managing patient relations grievances and/or complaints. Assist in identification, evaluation, and treatment of risk events within the hospital to reduce the frequency and severity of controllable unusual events, which may result in injury to patients or financial loss to the institution within the framework of the goals, objectives, and mission of SIH.

Education

Associates Degree in Nursing required Bachelor’s degree in Nursing preferred

Licenses and Certification

Current Illinois RN Licensure

Experience and Skills

• Technical Experience: 5 years May supervise staff intermittently in absence of Manager
• Ability to manage highly complex and uniquely challenging situations, requiring extensive consideration of variables that impact multiple areas outside of the job area.
• Ability to work independently with little supervision and provide general guidance, mentorship, or indirect supervision to colleagues.
• Ability to de‑escalate highly emotional and intense situations with patients/families, providers, and colleagues.

Role Specific Responsibilities

• Patient Relations (35%) Directly responsible for specific patient complaints/grievances in the form of face‑to‑face patient and family contact, letters, phone calls, emails, patient satisfaction surveys, and potentially other forms of communication (e.g. provider or employee communication);
• Directly responsible for Investigating concerns through collaboration with administration/Providers/Managers/Supervisors for timely responses to patients/families.
• Facilitates grievance meetings and acts as patient liaison.
• Directs patient inquiries and complaints to appropriate medical staff members and follows up to ensure satisfactory resultions.
• Explains policies, procedures, and services to patients using medical or administrative knowledge.
• Directly responsible for resolving the patient/family concern(s) in a formal written follow-up process within CMS guidelines.
• Assists with managing billing concerns related to patient/family complaint/grievance at the guidance of the facility Risk Manager.
• Directly responsible for collaborating with all levels of the organization to investigate patient lost belongings.
• Initiates the re‑imbursement process for replacement when warranted.
• Facilitates service recovery as specific occasions arise.
• Reads literature, talks with colleagues, continues education, and participates in professional organizations or conferences to keep abreast of developments in the field.
• Identifies and shares research, recommendations, or other information pertinent to patient/family satisfaction.
• Risk (65%) Directly responsible for reviewing/monitoring risk events in the monitors RDE (Remote Data Entry) reporting system.
• Directly responsible for investigating risk concern through chart reviews and collaboration with the Medical Staff members and staff.
• Directly responsible for managing communication with patients/families to ensure transparency, timeliness, and resolution.
• Identifies potential risks by analyzing data, observing processes, and talking to providers and staff.
• Ensures and/or facilitates adequate communication concerning key risks.
• Collaborates with Quality Peer Review Coordinator when cases are identified as potential peer issues.
• Responsible for timely referrals to Infection Prevention, Quality, Nursing, Ancillary Departments, Administration, and other departments as appropriate.
• Reviews patient charges for any pertinent adjustments and monitors for the completion of adjustments.
• Supervises office staff when manager is unavailable or otherwise engaged.
• Directly responsible for new provider orientation.
• Performs general employee and Nursing orientation.
• Assists with external requests for explants.
• Reads literature, talks with colleagues, continues education, and participates in professional organizations or conferences to keep abreast of developments in the field.
• Identifies and shares research, recommendations, or other information pertinent to legal liabilities, risk management or quality of care.

Compensation

Compensation (Commensurate with experience): $68827.2 To $106683.2

Equal Opportunity and Diversity Statement

SIH is an Equal Opportunity Employer including individuals with disabilities and protected veterans.

Workplace culture and benefits

At Southern Illinois Healthcare, we realize that in order to provide our surrounding communities with excellent care, we must begin by providing our employees with that same care and appreciation. We offer rich opportunities to develop and grow professionally, an environment of excellence in patient care, and the awareness that everything we accomplish is a direct outgrowth of the superb efforts and dedication of our employees. Working to put the right people, exhibiting the right attitude and behaviors, in the right roles is not just a goal, but a priority of Southern Illinois Healthcare.

For the health of you and our patients, SIH and SIH Medical Group campuses are tobacco free.

We are excited you are here and are proud to offer experiential learning opportunities for students at every stage of career development.

As a student at SIH, you will see first‑hand how the work we are doing supports OUR MISSION: to improve the health and well‑being of all the people in the communities we serve.

Your future is bright, and we are honored that you chose SIH to be part of your career journey.