Patient Grievance Case Management

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    "title": "Patient Grievance Case Management",
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    "datePosted": "2024-06-19T08:29:17.638Z",
    "description": "<h2>Department Overview</h2>\n<p>The Patient Grievance Case Management (GCM) position is responsible for the acknowledgement, facilitating</p>\n<p>investigation, follow-up, resolution, and documentation of patient complaints, grievances, concerns, and inquiries across all OHSU sites of care.</p>\n<p> </p>\n<p>They serve as an objective, person-centered partner for all parties involved in the complaint and grievance process — patients, families, and care team members alike. Rather than functioning as an advocate for any single party, this role is grounded in fairness, active listening, and a genuine commitment to understanding every perspective. The Case Manager works to ensure that each person involved feels heard, respected, and supported throughout the resolution process.</p>\n<p> </p>\n<p>Central to this role is the management of OHSU's formal complaint and grievance process. This includes receiving and documenting concerns through multiple channels, conducting thorough and impartial investigations, coordinating with clinical and administrative staff, and delivering timely written responses that meet departmental standards and Federal and State regulatory requirements. The Case Manager tracks and documents all activity within the complaint management system to support organizational reporting and quality improvement efforts. </p>\n<p> </p>\n<p>This is a demanding role that requires a high degree of professionalism and personal resilience. The work calls for exceptional organizational skills to manage multiple cases simultaneously, strong written and verbal communication to convey findings clearly and compassionately, and the emotional intelligence to navigate sensitive and often distressing situations with calm and care. Active listening, empathy, diplomacy, and the ability to remain objective under pressure are essential to performing this work effectively.</p>\n<h2>Function/Duties of Position</h2>\n<p><strong>Complaint and Grievance Case Management</strong></p>\n<p> </p>\n<p>Receives, investigates, and facilitates resolution of concerns brought by patients, families, and staff, serving as an objective and supportive partner for all parties involved. Concerns are received and addressed through multiple channels and settings, including:</p>\n<ul>\n <li>In-person meetings in departments, patient rooms, and clinical areas</li>\n <li>Phone, email, written correspondence, and electronic website submission</li>\n</ul>\n<p>Core responsibilities include:</p>\n<ul>\n <li>Gather facts and facilitate or implement resolutions in a manner that is respectful, diplomatic, and consistent with OHSU standards of practice and Federal and State regulatory requirements</li>\n <li>Practice with a high degree of independence, consulting and collaborating with the department leader on significant issues such as sentinel events, matters of policy, and complex grievances</li>\n <li>Provide written responses to patient grievances in accordance with departmental standards, OHSU policy, and regulatory requirements</li>\n <li>Document all complaints, grievances, and resolutions in the department complaint management system to support reporting and quality improvement trending</li>\n <li>Responding to questions and inquiries regarding OHSU policies and procedures, regulatory requirements, and State and Federal law as they relate to patient rights, responsibilities, and safety</li>\n <li>Serve as a knowledgeable resource and supportive contact for all members of the healthcare workforce on matters related to patient rights </li>\n <li>Act as an internal liaison to internal partners as needed to support patients and the OHSU workforce</li>\n <li>Engage with officials from community, State, or Federal agencies as circumstances require</li>\n</ul>\n<p><strong>Education, Policy, and Organizational Engagement</strong></p>\n<p> </p>\n<p>Supports the broader work of the Patient Relations department through education, policy development, and organizational participation. Responsibilities include:</p>\n<ul>\n <li>Provide staff education and training as assigned by the department leader, including through venues such as New Employee Orientation and departmental presentations</li>\n <li>Assist the department leader in the evaluation, revision, and creation of OHSU policies and procedures related to Patient Relations activities, including participation in and support of compliance with State and Federally regulated patient-care policies</li>\n <li>Participate in committees, outreach, and community assignments as directed by the department leader</li>\n</ul>\n<h2>Required Qualifications</h2>\n<ul>\n <li>Master's in social work, Counseling, Health Advocacy or similar academic preparation in HC related field </li>\n <li>3 years relevant clinical or social work experience, including conflict resolution and mediation skills. </li>\n</ul>\n<p><strong>Job Related Knowledge, Skills and Abilities (Competencies): </strong></p>\n<ul>\n <li>Exhibits a friendly and outgoing demeanor </li>\n <li>Demonstrates high-quality customer service to both external customers (patients) and internal customers (OHSU healthcare providers and staff) </li>\n <li>Demonstrates critical thinking and problem-solving skills </li>\n <li>Ability to manage and perform multiple tasks under conditions of fluctuating workloads, competing priorities, and changing deadlines </li>\n <li>Knowledge and demonstrated skill in the application of group dynamics collaboration, behavioral management, setting boundaries respectfully and explaining policies and procedures to individuals at various education levels.</li>\n <li> Ability to work independently and follow through on assignments with minimal direction · Knowledge of continuous quality improvement processes and tools </li>\n <li>Possesses excellent interpersonal, written, and oral communication skills </li>\n <li>Demonstrated experience in cultivating and fostering working relationships internally and externally </li>\n <li>Basic understanding of statistical and data analysis </li>\n <li>Strong understanding of HIPAA laws around privacy and confidentiality, with a demonstrated ability to manage sensitive information </li>\n <li>Ability to listen to or read a narrative then summarize and restate the main issues objectively, concisely, and without bias </li>\n</ul>\n<h2>Preferred Qualifications</h2>\n<ul>\n <li>Experience in healthcare administration </li>\n <li>Knowledge of SharePoint </li>\n <li>Knowledge of Epic </li>\n <li>Knowledge in RLDatix </li>\n</ul>\n<h2>Additional Details</h2>\n<p>Monday through Friday, 8:00 to 4:30. This is a Critical Function Employee position. The role is hybrid, with onsite presence required on a rotating schedule coordinated with other Patient Grievance Case Managers to ensure consistent coverage across OHSU Hospitals and Clinics. Remote work is available for a portion of the schedule, subject to supervisor approval and operational needs.</p>",
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