Program Specialist- Customer Relations

Veterans Health Care System of the Ozarks; Fayetteville (AR); On-site; USD 65,000 - 95,000; Full time

Job summary

Veterans Health Care System of the Ozarks is seeking a Customer Service Program Specialist aligned under the Care in the Community (CITC) Program to support executive leadership and oversee patient relations, access to care, and service excellence.

The role focuses on consult management, data analysis of complaints, and coordination to improve veteran care experiences in line with Mission Act and Community Care programs.

Responsibilities

• The primary purpose of this position is to improve the veteran and Care in the Community (CITC) care provider experience with CITC care.
• Manages the CITC customer relations process, including complaint resolution, data capture and analysis of issues/complaints to make system improvements.
• Performs reviews by examining Veteran's medical records, CITC care authorizations, CITC care payment records and historical tracking of submitted health care claims.
• Applies specialized knowledge of healthcare planning, project management, organizational structure, and evaluation of care delivery routines.
• When a complaint is identified, explores all avenues, crossing all lines of authority and responsibility within the medical facility, in order to properly identify the nature and scope of the problem and to initiate appropriate action to expedite a resolution.
• Liaison between the Facility, patients, staff, and the community, ensuring Patient Rights and Responsibilities, advocacy, and services are available.
• Interprets the Facility's mission, policies, procedures, and available resources/services to the patient and presents the patient's concern, opinions, and needs to appropriate staff and management.
• Serves as a staff member directly supporting facility Executive Leadership responsible for planning, organization, development, direction and evaluation of VA Medical Facility administration.
• Ensures VHA

Job description

Summary

This position reports to the Service Chief or Program Manager and serves as the Customer Service Program Specialist and will be organizationally aligned under the Care in the Community (CITC) Program under the Chief of Staff performing key duties and will serve as the service excellence specialist in the areas of consult management analysis, administration, and coordination in support of the Mission Act and Community Care programs.

Major Duties

The primary purpose of this position is to improve the veteran and Care in the Community (CITC) care provider experience with CITC care. Manages the CITC customer relations process, including complaint resolution, data capture and analysis of issues/complaints to make system improvements. Performs reviews by examining Veteran's medical records, CITC care authorizations, CITC care payment records and historical tracking of submitted health care claims. Applies specialized knowledge of healthcare planning, project management, organizational structure, and evaluation of care delivery routines. When a complaint is identified, explores all avenues, crossing all lines of authority and responsibility within the medical facility, in order to properly identify the nature and scope of the problem and to initiate appropriate action to expedite a resolution. Diplomacy, good judgment, compassion, flexibility, and a good sense of humor are required to work with the diversity of patients, family and staff and the complexity and sensitivity of issues which have the potential of controversy or legal action. Serves as the liaison between the Facility, patients, staff, and the community, ensuring Patient Rights and Responsibilities, advocacy, and services are available. Interprets the Facility's mission, policies, procedures, and available resources/services to the patient and presents the patient's concern, opinions, and needs to appropriate staff and management. Serves as a staff member directly supporting facility Executive Leadership responsible for planning, organization, development, direction and evaluation of VA Medical Facility administration. Ensures VHA