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Job Summary

Evaluates the quality of health careby evaluating the quality of services ordered or performed by the System's professional health care providers including practice analysis, inpatient hospital and extended care facility utilization reviews, medical audits, ambulatory care reviews, claims reviews, and the compliance any health care facilities within the System. Responsible for coordinating and implementing the Performance Improvement goals and objectives, specifically those related to customer service, patient satisfaction and clinical risk management.

Job Duties

• Collects and analyzes patient complaint and grievance data to identify opportunities to improve patient and customer services in a collaborative role with management.
• Investigates and analyzes patient and family allegations and concerns by listening to patient family complaints, document detailsto verify content and facts and to assist the organization's administration in the resolution of the grievance.
• Develops a consultant relationship with assigned clinics and units to build and sustain a patient and customer focused culture.
• Collaborates and coordinates with medical staff, administration, clinical operations, and support staff to facilitate prompt resolution of patient-related grievances and service issues.
• Serves as a liaison between staff, patients, and families to provide requested information, including resolution of a grievance in a family and provider meeting forum.
• When necessary, educates patients and families regarding reasonable service expectations.
• Provides written and verbal responses to accurately reflect patients' concerns and grievances and the organization's responses.
• Effectively communicates to specific groups including families, patients, staff, students in order to educate on Patient's Bill of Rights philosophy by visiting them; introducing them to the patient right's brochure; confirming their understanding of who to contact with questions or concerns.
• Participates in the investigation, documentation, and patient and family communication relative to concerns that carry potential risk and loss to the organization with risk management.
• Coordinates efforts to assure compliance with regulatory standards relative to handling patient complaints and grievances including participation on assigned committees and work groups as needed.

Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Position Details

Work Schedule/Details:

• 40 hours weekly
• Day Shift - flexible hours
• No weekends or holidays

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Geisinger cares about not only its patients and members but also about you and your family. We offer a competitive compensation and benefits package to ensure that you and your loved ones can maintain good health, achieve financial stability, and excel both personally and professionally.

Our benefits package includes:

• Comprehensive health insurance coverage starting on your first day of employment with three medical plan options, including flexible spending account (FSA) and health savings account (HSA) options
• Life insurance, short-term disability, and long-term disability coverage paid for by the company
• A competitive 401(k) plan with automatic Geisinger contributions beginning on your first day of employment
• A generous paid time off (PTO) plan that allows you to accrue time quickly
• Access to the MyHealth Rewards wellness program, which helps you improve your health and earn incentives
• Support for families, including adoption assistance, paid parental leave, paid military leave, and a free care.com membership with discounted backup care for your loved ones
• We believe in creating a diverse and inclusive environment where all employees can be their authentic selves. That's why we offer several Employee Resource Groups (ERGs), which provide opportunities for you to network and develop professionally. Our ERGs are open to all employees and are formed around common identities.

To learn more about our benefit offerings, please visit: https://www.paperturn-view.com/radancy-geis/135344-geisinger-2023-benefits-general?pid=MzA300191&v=1.1

Education

Graduate from Specialty Training Program-Nursing (Required)

Experience

Minimum of 3 years-Nursing (Required)

Certification(s) and License(s)

Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.

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