Patient Risk Relations Specialist

Southern Illinois Healthcare; Carbondale (IL); Hybrid; USD 69,000 - 107,000; Full time

Job summary

Southern Illinois Healthcare in Carbondale, IL seeks an experienced professional to manage patient relations grievances and oversee risk events within the hospital to reduce harm and financial loss. This role requires strong de-escalation skills, effective communication, and collaboration with multiple departments.

The incumbent will investigate concerns, coordinate with leadership, and guide teams toward timely, compliant resolutions consistent with CMS guidelines.

Qualifications

• Requires an Associate's Degree in Nursing; a Bachelor's Degree is preferred.
• Current Illinois RN Licensure is required.
• Minimum 5 years of technical experience in healthcare/risk management.
• Strong ability to de-escalate high-stress situations and guide staff.

Responsibilities

• Directly handle patient complaints/grievances via face-to-face contact, calls, letters, and surveys.
• Investigate concerns with administration, providers, and managers to provide timely responses.
• Facilitate grievance meetings and serve as patient liaison; ensure satisfactory resolutions.

Skills

Patient relations

Risk management

De-escalation

Communication

Supervision

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

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