REMOTE Website / CMS Specialist

The Patient Family Relations Specialist is responsible for emails, visits and correspondence to serve as a liaison between patients, loved ones, and staff in acknowledging and responding to feedback (complaints, grievances, compliments) and other requests in a compassionate and supportive manner. The focus of this position is to support patient rights, patient and family needs, and to assist in resolving feedback concerns and highlighting feedback compliments. This role embodies the institution's commitment to a strong patient and family centered culture and service excellence. The PFR specialist reports to the Senior Manager, Patient and Family Relations. Is this the next step in your career Find out if you are the right candidate by reading through the complete overview below. Because this role in an active change management environment, the senior specialist will need to demonstrate maturity, flexibility, and open mindedness as the contours of this position will actively evolve over time.

Principal Duties and Responsibilities: Provides in person support of Patient and Family Relations for the needs of patients and loved ones, concerns, or complaints at AMC hospitals. Meets patients and families in the ED, inpatient units, and the PFR office. With guidance from the Sr. Manager, Patient and Family Relations, conducts timely investigations and responses to patient concerns, complaints, grievances, including interviewing staff and reviewing medical records. Facilitates effective communication between patients, families, and staff to enhance patient/family-centered care and ensure common goals. Mediates and mitigates expectations to promote satisfaction, ensure quality and safety, and minimize the risk of adversarial outcomes. Supports patients and families in understanding patient rights and responsibilities, responds to patient complaints or concerns in accordance with DPH, CMS and The Joint Commission regulatory standards for patient complaints and grievances. Participates in family meetings and Apology and Disclosure conversations as requested. Serves as a resource to care teams in managing challenging behaviors and patient dismissals. Documents information regarding patient and/or staff concerns and requests in confidential department database and disseminates data to appropriate leadership staff for quality assurance purposes. Uses department database to meet regulatory requirements for CMS, DPH and The Joint Commission for grievance/complaint management and resolution process. Rounds with patients and loved ones to obtain preemptive feedback regarding the inpatient hospital experience (when appropriate and aligned with hospital safety policies). Prepares formal correspondence and documentation (both patient-facing and internally) such as letters, messages, and reports, with efficiency and accuracy. Identifies patterns of service breakdowns and escalates to senior manager to share with Patient Experience measurement and improvement team. Diversity, Equity, and Inclusion (DEI) - Demonstrate a commitment to supporting MGB DEI initiatives, using the organizational tools and training provided to help identify and dismantle systemic racism within departmental processes, and all other forms of possible discrimination. Other duties as assigned.

• Manages a timely investigation and response to all patient concerns/complaints/grievances for clinical service areas including interviewing staff and reviewing medical records. Facilitates effective communication between patients, families, and providers to enhance patient/family-centered care and ensure common goals. Negotiate and mitigate expectations to promote satisfaction, ensure quality and safety, and minimize the risk of adversarial outcomes.
• Provide consultation for professional staff and hospital regarding disclosure in collaboration with Risk Management.
• Responds to requests for intervention to assist in managing difficult patient/family situations. Collaborates with clinical service area management and administrative leadership, frontline staff, or other hospital services to provide real-time support and/or improvement strategies to reach effective resolution. Accessible by pager during Family Center's hours of operation.
• Documents information regarding patient and/or staff concerns and requests in the department database and disseminates data to appropriate leadership staff for quality assurance purposes. Generates specific reports to highlight clinical service areas' opportunities for improvement efforts, including progress, obstacles, and trends in compliment/complaint data. Review data to identify trends in collaboration with clinical and administrative leadership to develop strategies to improve quality and satisfaction and reduce risk and liability. Utilizes data management system to meet regulatory requirements for CMS, DPH, and JCAH for complaint management and resolution process.
• Drafts