Clinical Patient Advocate - Milford Regional 40 hours, Days

Exemption Status:

Hiring Range:

Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations.

Schedule Details:

Scheduled Hours:

Shift:

Hours:

Cost Center:

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

I. Major Responsibilities:

1. Responsible for medical, behavioral, nursing, operational grievances (when a patient or family would like to have their care or a loved one's care formally reviewed by the hospital). This includes interviewing the patient and family on what care they would like reviewed and conducting a thorough review of the medical record to determine if the review needs to be escalated to a Physician Quality Officer or anyone in hospital leadership. The Clinical Patient Advocate determines if all aspects of the care were reviewed and collaborates with the team to complete a comprehensive review.

2. Maintains a close working relationship with clinical care teams across the organization to identify potential patient complaints before they arise. Liaison with patients/visitors to ensure care is consistent with expectations and facilitates resolution of inconsistencies

3. Responsible for oversight of patient clinical, behavioral, nursing and operational grievances assigned to the Patient Advocate. Conducts a thorough medical review with the assistance of the physician quality officer, nursing leadership and hospital leadership.

4. Presents patient clinical grievances to the grievance committee and is responsible for all follow through and coordination which also includes formal communication to the patient and family. Responsible for investigating, resolving, documenting, communicating and reporting patient/visitor complaints and concerns, and ensuring regulatory compliance. This includes collaborating with clinicians and creating the formal patient grievance letter to patients and insurance carriers.

5. Responsible for the appeals process which is when the patient is not satisfied with the medical review. Responsible for scheduling and coordinating family meetings that are related to disclosures and clinical reviews. Arranges, mediates, and facilitates meetings between patients and/or staff to foster satisfactory resolution.

6. Coordinates efforts with all necessary areas of the organization (especially: Legal, Public Relations/Marketing/Communications, Risk Management, Regulatory Affairs, etc.) to resolve complaints, and address issues to prevent future complaints

II. Position Qualifications:

License/Certification/Education:

Required:

1. Active licensure in a clinical healthcare profession (e.g., RN, LPN, LICSW, Respiratory Therapist, Physical Therapist, or equivalent), with demonstrated experience in patient care, care coordination, and interdisciplinary collaboration.

Preferred:

1. Master's Degree in Nursing or related healthcare field

Experience/Skills:

Required:

1. Must have at least 5 years of clinical experience within their licensed field.

2. Demonstrated knowledge and expertise in clinical care and management of care.

3. Prior experience in conducting independent clinical assessments. Ability to present findings to department leadership and the grievance committee.

4. Must have strong organizational, analytical and computer technology skills.

5. Excellent writing skills to be used in documenting accurate case reports and in writing to patients on behalf of the institution.

6. Excellent communication, mediation and facilitation skills. Excellent oral presentation skills to be used in speaking to staff at all levels regarding patient issues.

7. Demonstrated experience with data collection and analysis.

8. Demonstrated ability to handle appropriately: sensitive, confidential information.

9. Skillful in interacting with all levels of the institution, showing good judgment in mediating patient complaints.

Manage the CARe program

• Lead the organization's Communication, Apology, and Resolution (CARe) Program to promote transparency, trust, and patient-centered response following adverse events and patient safety incidents.
• Develop and maintain CARe policies, procedures, educational materials, and communication tools.
• Serve as the primary coordinator for CARe activities involving patients, families, providers, leaders, and risk management.
• Ensure timely, compassionate, and effective communication with patients and families following adverse events, unexpected outcomes, and safety concerns.
• Facilitate unexpected event conversations between clinical teams and patients/families in accordance with organizational policies and best practices.
• Collaborate with Quality, Patient Safety, Risk Management, Compliance, and Clinical Operations to ensure a consistent organizational response to events.
• Track and monitor CARe cases from identification through resolution, ensuring timely follow-up and documentation.

Manage the Service Excellence Program

• Lead initiatives designed to improve patient and family experience across all care settings.
• Analyze experience data and identify opportunities to improve patient perceptions of care.
• Partner with operational and clinical leaders to develop and implement improvement plans.
• Facilitate the Engagement & Experience Committee.

Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.