Manager Customer Service

Job Summary/Overall Objectives

Manages the Customer Care Department and staff that are responsible for the complaint/grievance process. Ensures that the hospitals are compliant with regulatory body requirements for the management of patient complaints and grievances. Works closely with the Chief Quality Officer to ensure that customer care coordinators maintain compliance with CMS standards in documentation and grievance follow up. Serves as the lead person for the investigation, reporting and resolution of patient grievances. Serves as liaison between patients, families, visitors, hospital staff, and medical staff. Utilizes various tools such as service recovery, the complaint/grievance process, listening/discovery sessions, process improvement activities, educational opportunities and/or improved communication strategies. Enhances patient and family awareness of the institution's responsiveness to concerns. Displays each hospital's overall commitment to exceptional delivery of patient care by imparting a caring attitude and prompt responsiveness, which is critical to the continued success of the organization. Serves as the system leader and subject matter expert in the area of patient relations. Is responsible for regular reports to the patient grievance committees and for the preparation and distribution of the patient grievance committee agenda and meeting records. Participates in Patient Safety and Risk Management Operations by identifying potential liability in complaints received and works with finance to adjudicate payment in the occurrence of never events. In conjunction with Data Management personnel, compiles statistical data and provides trend reports as requested. Reports data trends periodically to key stakeholders as needed.

Essential Job Responsibilities

• The position is responsible for leading the department and accountable for customer care.

• This position has direct supervisory responsibilities such as hiring, coaching/mentoring, skills development, recognition and rewards, staff productivity, performance management and succession planning.

• Equitably and consistently apply and practice policies and procedures for all staff.

• Develop and manage department budget at or below budget expectations and consistent with adjusted volume variations.

• Identify and implement revenue enhancement opportunities. Support the execution of company strategy across business segments to optimize experience and results.

• Establish and maintain a safe working environment; assure staff comply with safety, environmental, and infection control guidelines.

• Review, research and evaluate complaints and grievances to determine appropriate response based on CMS guidelines and hospital policy.

• Oversees referral, investigation, and resolution of complaints/grievances independently and coordinates response by involved departments.

• Keeps appropriate parties informed and involved, completes appropriate follow up and completes resolution of complaints/grievances within the outlined required time frames to keep the hospital in compliance with regulatory, federal, and state agencies.

• Maintains compliance with CMS Centers for Medicare and Medicaid Services Conditions of Participation, other regulatory standards, and hospital policy.

• Facilitates required grievance committee, as well as prepares annual reporting as outlined in the CMS Conditions of Participation.

• Documents 100% of complaints and grievances received.

• Provides data for centralized database of patient complaints/grievances and assists with reporting of patient satisfaction/patient complaints as requested.

• Participates in Patient Safety and Risk Management Operations by identifying potential liability in complaints received.

• Understand, analyze, and communicate patient experience survey data - identifying trends, areas for improvement, and learn about and share best practices for optimal outcomes.

• Communicate with inpatient leadership about specific feedback (compliments/complaints/changes in site metrics), involvement in developing solutions and resolving issues.

• Work with Inpatient Leadership on developing doable, sustainable, and measurable strategies for improvement.

• Improve HCAHP scores according to fiscal year targets; demonstrate year after year improvement in service to internal and external customers.

• Other duties as assigned.

Competency and Experience [Knowledge, Skills and Abilities]

Required Qualifications/Experience

• Bachelor's degree in nursing or related fields of human resource management, health policy and/or health care administration and five (5) years of customer service, social work or related field experience.

• Two (2) - four (4) supervisory/management experience.

• Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects and liability of nursing practice.

• Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience.

• Proficiency in the use of Excel Spreadsheets, PowerPoint, and various software programs.

Preferred Qualifications/Experience

• Master's degree in nursing, human resources management, health policy and/or health care administration preferred.

License, Certification & Clearances

• Current licensure to practice in field based on educational program in the State of Pennsylvania if applicable.

• Act 34-PA Criminal Record Check from the PA State Police system.

Position Type/Expected Hours of Work

• Incumbent will be scheduled based on operational need (rotate shifts, standby, on-call, etc.).

• Travel may be expected locally between System locations.

Equal Employment Opportunity

Independence Health and its affiliated companies are Equal Opportunity Employers. It is their policy to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, veteran status, or genetic information, or any other classification protected by law. Independence Health and its affiliated companies will comply with all applicable laws and regulations.

Disclaimer

This job description is not designed to contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee. Moreover, duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Work Environment

Effective March 2020 or during pandemic: goggles, face shield and mask are required according to CDC guidelines

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Essential

• Absolute Necessity.

Marginal

• Minimal Necessity.

Constantly

• 5.5 to 8 hours or more or 200 reps/shift.

Frequently

• 2.5 to 5.5 hours or more or 32-200 reps/shift.

Occasionally

• 0.25 to 2.5 hours or 2-32 reps/shift.

Rarely

• Less than 0.25 hours or less than 2 reps/shift.

Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Extreme Heat

X

Extreme Cold

X

Heights

X

Confined Spaces

X

Extreme Noise(>85dB)

X

Mechanical Hazards

X

Use of Vibrating Tools

X

Operates Vehicle (company)

x

Operates Heavy Equipment

X

Use of Lifting/Transfer Devices

X

Rotates All Shifts

X

8 Hours Shifts

X

X

10-12 Hours Shifts

X

X

On-Call

X

Overtime(+8/hrs/shift; 40/hr/wk)

X

Travel Between Sites

X

X

Direct Patient Care

X

Respirator Protective Equipment

X

Eye Protection

X

Head Protection (hard hat)

X

Hearing Protection

X

Hand Protection

X

Feet, Toe Protection

X

Body Protection

X

Latex Exposure

X

X

Solvent Exposure

X

Paint (direct use) Exposure

X

Dust (sanding) Exposure

X

Ethylene Oxide Exposure

X

Cytotoxic (Chemo) Exposure

X

Blood/Body Fluid Exposure

X

Chemicals (direct use) Exposure

X

Mist Exposure

X

Wax Stripper (direct use)

X

Non-Ionizing Radiation Exposure

X

Ionizing Radiation Exposure

X

Laser Exposure

X

Physical Demands

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Essential

• Absolute Necessity.

Marginal

• Minimal Necessity.

Constantly

• 5.5 to 8 hours or more or 200 reps/shift.

Frequently

• 2.5 to 5.5 hours or more or 32-200 reps/shift.

Occasionally

• 0.25 to 2.5 hours or 2-32 reps/shift.

Rarely

• Less than 0.25 hours or less than 2 reps/shift.

Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Bending (Stooping)

X

X

Sitting

X

X

Walking

X

X

Climbing Stairs

X

X

Climbing Ladders

X

Standing

X

X

Kneeling

X

Squatting (Crouching)

X

X

Twisting/Turning

X

Keyboard/Computer Operation

X

X

Gross Grasp

X

X

Fine Finger Manipulation

X

X

Hand/Arm Coordination

X

X

Pushing/Pulling(lbs. of force)

X

<10#

Carry

X

<5#

Transfer/Push/Pull Patients

X

Seeing Near w/Acuity

X

X

Feeling (Sensation)

X

Color Vision

X

X

Hearing Clearly

X

X

Pulling/Pushing Objects Overhead

X

Reaching Above Shoulder Level

X

X

Reaching Forward

X

X

Lifting Floor to Knuckle

X

<10#

Lifting Seat Pan to Knuckle

X

Lifting Knuckle to Shoulder

X

Lifting Shoulder to Overhead

X

When lift requirement is in excess of

50#, lift assistance (2 person) and/or transfer device is required