Job Summary

Evaluates the quality of health careby evaluating the quality of services ordered or performed by the System's professional health care providers including practice analysis, inpatient hospital and extended care facility utilization reviews, medical audits, ambulatory care reviews, claims reviews, and the compliance any health care facilities within the System. Responsible for coordinating and implementing the Performance Improvement goals and objectives, specifically those related to customer service, patient satisfaction and clinical risk management.

Job Duties

• Collects and analyzes patient complaint and grievance data to identify opportunities to improve patient and customer services in a collaborative role with management.

• Investigates and analyzes patient and family allegations and concerns by listening to patient family complaints, document detailsto verify content and facts and to assist the organization's administration in the resolution of the grievance.

• Develops a consultant relationship with assigned clinics and units to build and sustain a patient and customer focused culture.

• Collaborates and coordinates with medical staff, administration, clinical operations, and support staff to facilitate prompt resolution of patient-related grievances and service issues.

• Serves as a liaison between staff, patients, and families to provide requested information, including resolution of a grievance in a family and provider meeting forum.

• When necessary, educates patients and families regarding reasonable service expectations.

• Provides written and verbal responses to accurately reflect patients' concerns and grievances and the organization's responses.

• Effectively communicates to specific groups including families, patients, staff, students in order to educate on Patient's Bill of Rights philosophy by visiting them; introducing them to the patient right’s brochure; confirming their understanding of who to contact with questions or concerns.

• Participates in the investigation, documentation, and patient and family communication relative to concerns that carry potential risk and loss to the organization with risk management.

• Coordinates efforts to assure compliance with regulatory standards relative to handling patient complaints and grievances including participation on assigned committees and work groups as needed.

Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Position Details

• Hours: Typical hours are between 8 am and 4:30 pm

• Travel: Yes, this role will cover the Northeast hospitals between Scranton and Wilkes Barre - up to 50% travel

• Required experience: 3 years of RN experience

• Preferred experience: 1 year of hospital-based work experience, BSN, and bilingual

  Geisinger cares about not only its patients and members but also about you and your family. We offer a competitive compensation and benefits package to ensure that you and your loved ones can maintain good health, achieve financial stability, and excel both personally and professionally. We believe in creating a diverse and inclusive environment where all employees can be their authentic selves. To learn more: https://jobs.geisinger.org/diversity

Benefits of working at Geisinger:

• Full benefits (health, dental and vision) starting on day one

• Three medical plan choices, including an expanded network for out-of-area employees and dependents

• Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA)

• Company-paid life insurance, short-term disability, and long-term disability coverage

• 401(k) plan that includes automatic Geisinger contributions

• Generous paid time off (PTO) plan that allows you to accrue time quickly

• Up to $5,000 in tuition reimbursement per calendar year

• MyHealth Rewards wellness program to improve your health while earning a financial incentive

• Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones

• Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.

• Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance

Education

Graduate from Specialty Training Program-Nursing (Required)

Experience

Minimum of 3 years-Nursing (Required)

Certification(s) and License(s)

Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.