Grievance Specialist

Children's Hospital Of Philadelphia Philadelphia , PA 19107

Posted 2 months ago


Job Description

Req ID: 22162

Shift: Days

Employment Status: AF - Active

  • Regular

  • Full Time

Job Summary

The Grievance Specialist is an institutional expert assessing the management and disposition of written correspondence to and from patients and families in accordance with critical regulatory laws, rules, regulations (CMS, JCAHO, and DOH.) The Grievance Specialist will be responsible for guiding and coordinating the overall grievance process for responding to and resolving all verbal and written complaints and grievances from patients and families related to their concerns. The grievance specialist will partner and collaborate with local leaders to successfully address patients and families' grievances and complaints by identifying factors necessary for the optimal resolution of complaints and incorporating into written correspondence to patients and families. The Grievance Specialist will provide assistance and oversight and education to local leaders in responding to patient/family complaints and grievances.

Under the direction of the Manager of the Office of Feedback, the grievance specialist will be responsible for maintaining highly sensitive materials and data that is essential for Hospital compliance with regulatory requirements. The position is responsible for maintaining the privacy and confidentiality of information, acting with ethics and integrity, reporting noncompliance, adhering to company policy and procedures, including accreditation requirements, applicable federal, state and local laws and regulations.

Job Responsibilities

Clinical Excellence: (80%)

  • Interprets CMS, JCAHO, DOH laws, regulations, rules, for management of written correspondence to patients/families. Will carry an active grievance caseload and is also responsible for ensuring prompt resolution of patient complaints/grievances.

  • Maintain working relationships with local leaders throughout the CHOP system and serves as an advisor and support in investigating and responding to patient/family complaints. Provides expert advice to local leaders, physicians and executives on information and interpretation of the organization's grievance policies, procedures and guidelines when the issues presented require substantial interpretation.

  • Uses good judgment to identify all issues and required actions to successfully resolve and respond to incoming complaints. Prepares written responses as appropriate in the resolution of grievances.

  • Informs management of regulatory and other requirements to be considered when corresponding, and resolving grievances. Collaborates with leaders in Regulatory, Legal, and Risk Management to ensure compliance with applicable laws and regulations.

  • Participates in meetings to review incoming complaints and provide accountability for the disposition of closed complaints and grievances.

  • Maintains confidential records; enters information into appropriate databases in a timely manner. Provides on-going review and work with identified staff and key stakeholders to ensure appropriate follow-up to any outstanding concerns are addressed and provide ongoing assistance for assigned areas.

Program Development: (10%)

  • Consults on the development of departmental standards and role models professional behaviors that promote collaborative relationships with local and executive leaders.

  • Represents and provides the family-center care perspective on hospital-wide committees.

  • Conducts departmental and organizational in-services for new staff, and/or hospital staff.

  • Participates in the review, revision, and development of Policies & Procedures to reflect hospital and professional practice standards for handling complaints and grievances.

Job Responsibilities (Continued)

Quality/Process Improvement: (10%)

  • Partners with department leadership team to execute plans to improve patient/family experiences which includes identifying trends and establishing systems to improve.

  • With Office of feedback leadership, tracks and trends the sources of complaints and grievances in an effort to make proactive improvements to reduce complaints.

  • Ensures services meet professional standards and regulatory requirements.

Job Responsibilities (Continued)

Required Licenses, Certifications, Registrations

Required Education and Experience

Required Education: Master's in Social Work or Nursing,

Required Experience: At least five (5) years in a Hospital

Preferred Education, Experience & Cert/Lic

Additional Technical Requirements

  • Ability to provide exceptional clinical social work or nursing leadership.

  • Ability to identify and define problems, collect data/information, establish facts, and draw valid conclusions.

  • Knowledgeable and compliant with all relevant laws, rules, regulations and accreditation standards and requirements.

  • Ability to work independently.

  • Ability to perform multiple task simultaneously, work under pressure and meet critical deadlines.

  • Must possess a high degree of professionalism and business ethics.

  • Exceptional writing skills.

  • Performs work according to CHOP policies and procedures, professional standards of care, and applicable laws.

  • Ability to set goals, prioritize, and achieve results in accordance with the highest standards.

  • Communicates with sensitivity and respect.

  • Understands and promotes CHOP's mission.

  • Ability to prioritize and complete duties in a timely and organized manner.

  • Works collaboratively and in a positive manner with others.

  • Ability to train and coach staff.

  • Ability to demonstrate professional and leadership skills.

All CHOP employees who work in a patient building or who provide patient care are required to receive an annual influenza vaccine unless they are granted a medical or religious exemption.

Children's Hospital of Philadelphia is committed to providing a safe and healthy environment for its patients, family members, visitors and employees. In an effort to achieve this goal, employment at Children's Hospital of Philadelphia, other than for positions with regularly scheduled hours in New Jersey, is contingent upon an attestation that the job applicant does not use tobacco products or nicotine in any form and a negative nicotine screen (the latter occurs after a job offer).

Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability or protected veteran status.

VEVRAA Federal Contractor/Seeking priority referrals for protected veterans. Please contact our hiring official with any referrals or questions.

CHOP Careers Contact

Talent Acquisition
2716 South Street, 6th Floor

Philadelphia, PA 19146

Phone: 866-820-9288

Nearest Major Market: Philadelphia

Job Segment: Medical, Patient Care, Healthcare

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Grievance Specialist

Children's Hospital Of Philadelphia