Responsible for addressing 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.
Role Specific Responsibilities
o Reviews/monitors RDE (Remote Data Entry) reporting system
o Performs chart reviews on risk and patient relations issues for prevention of claims, outcomes, and potential disclosure issues
o Identifies events for PSPI (Patient Safety Process Improvement) and presents topics at PSPI
o Assists in coordination and chairing (when needed) PSPI
o Collaborates with Quality Peer Review Coordinator when cases are identified as potential peer issues
o Responsible for timely referrals to Infection Prevention, Quality, Nursing, Ancillary Departments, and Administration
o Reviews patient charges for any pertinent adjustments and monitors for the completion of adjustments
o Assists in monitoring/reviewing monthly PFS (Patient Financial Services) reports in regards to risk and patient relations billing/ adjustments.
o Works with Managers/supervisors for timely responses to patient relations and identified risk issues, for completion and closure
o Supervises office staff when manager is unavailable or otherwise engaged
o Performs new Staff orientation and Nursing specific orientation
o Presents at new Physician orientation (as needed in absence of manager)
o Participates in hospital based or system wide committee and/or teams
o Assists in RCA identification, investigation, and planning
o Responsible for initial risk identification, investigation, and evaluation to reduce the frequency and severity of controllable unusual events
o Receives specific patient complaints/grievances in the form of patient satisfaction surveys, letters, phone calls, emails, and potentially other
forms of communication; investigates and resolves the matter in a formal written follow-up process within CMS guidelines
o Facilitates grievance meetings and acts as patient liaison
o With the help of Unit Managers/supervisors, investigates loss of patient items and initiates the re-imbursement process for replacement when
o Facilitates service recovery as specific occasions arise
• Bachelor’s degree in Nursing preferred.
Licenses and Certification
• Current Illinois RN Licensure required.
Experience and Skills
• Technical Experience: 3 years - preferably with experience in Acute Care & OB settings