Patient Experience Service Review Manager Patient Experience Service Review Manager 1 day ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Direct message the job poster from Onvida Health Director of Talent Acquisition @ Onvida Health Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Varied Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $91,359.84 Mid = $118,767.80 Max = $146,175.75 Summary: The Patient Experience Service Review Manager, RN will play an active role in investigating and resolving complaints and grievances to maintain the highest levels of patient care. This position aligns for someone who is a clinically adept problem-solver who thrives in dynamic, fast-paced settings. This position is committed to enhancing healthcare through comprehensive investigation, resolution, and collaboration with teams, providers, and leaders. This position will help manage the grievance process and support care advocacy initiatives to ensure compliance with CMS and DNV standards. The Service Review Manager will also utilize their knowledge to evaluate complaint allegations and engage with cross-functional stakeholders to drive effective resolutions and ensure timely and effective resolution of care concerns. This role will also monitor grievance trends, track Key Performance Indicators (KPIs), and apply data-driven insights to enhance quality of care delivery, improve patient experience, and support organizational reputation. This role will supervise the Patient Experience Care Advocate Specialists. Responsibilities: Grievance Process Management: Supports grievance management process from intake through resolution, ensuring all Supports grievance management process from intake through resolution, ensuring all grievances are documented, tracked, and resolved within CMS and DNV regulatory timelines. Manages complex or escalated grievances, ensuring timely and effective resolution in alignment with organizational goals and regulatory requirements. Monitors grievance data and trends to identify recurring issues and areas for process improvement. Maintains accurate and detailed records of all grievances, appeals, and resolutions. Ensures resolution are in accordance with regulatory requirements, organizational policies, and best practices Leads and supervises the Experience Care Advocate Specialists ensuring effective management and support. Grievance Committee Support: Co-facilitate grievance committee meetings, ensuring comprehensive review and resolution of grievances and appropriate action. Prepares reports, presentations, and case materials for the grievance committee to ensure timely and well-informed decision-making. Ensures that all committee decisions align with CMS, DNV, and organizational policies, and communicate outcomes clearly to patients and relevant stakeholders. Collaboration and Communication Collaborates with other departments, such as clinical teams, quality improvement, and administration, to address patient concerns and ensure resolution.· Works closely with the Patient Experience team to develop strategies for enhancing patient experience based on review data. Communicates effectively with patients, both in writing and over the phone, to acknowledge feedback and inform them of any follow-up actions. Serves as a liaison between patients, families, and various departments to ensure that concerns are addressed quickly and appropriately. Addresses complex or high-stakes grievances or care concerns, demonstrating strong problem-solving and conflict resolution skills. Data Analysis and Reporting: Collects and analyzes grievance-related data to identify trends and measure performance against qualitative insights and quantitative data monitoring and tracking Key Performance Indicators (KPIs). Provides data-driven insights on grievance trends, patient care outcomes, and care advocacy efforts to senior leadership. Reports on grievance metrics, including resolution time to ensure continuous improvement. Ensures all patient reviews and communications are handled in compliance with HIPAA and other relevant privacy regulations. Maintains confidentiality and security of patient information at all times. Regularly evaluate the grievance management process to ensure compliance with CMS, DNV, and other applicable regulations. Identifies opportunities for process improvement based on grievance trends, patient feedback, and internal audits. Stays updated on changes in CMS, DNV, and other relevant regulations to ensure ongoing compliance with grievance handling standards. Training and Education: Supports training sessions for staff on grievance management processes and CMS/DNV compliance requirements. Creates educational materials and resources to enhance staff understanding of grievance procedures and the importance of patient advocacy. Fosters a culture of proactive care advocacy and patient-centered care throughout the organization. Reviewing Patient Medical Records: Reviews patient medical records as part of the grievance investigation process to gather relevant information and provide evidence-based findings. Utilizes clinical knowledge to assess the accuracy and quality of care provided and ensure that grievance cases are resolved with appropriate medical evidence. Documents and present findings based on patient records, ensuring that decisions are backed by clinical facts and align with evidence-based practices. Other duties as assigned Credentials:
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