Clinical Patient Advocate - Milford Regional 40 hours, Days

About this role

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Exemption Status: Exempt Hiring Range: $91,312.00 - $164,361.60 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: Monday through Friday Scheduled Hours: 8:00 am - 4:30 pm flex Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 26000 - 6222 Performance Improvement This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

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.

Responsible for oversight of patient grievances and organizing the behavioral, nursing, operational and medical reviews which includes collaboration with physician leadership, hospital leadership, patient safety, quality improvement and risk management. Serves as a liaison between our patients/visitors and the organization. Responsible for collaborating with stakeholders across the organization to work towards the prevention and remediation of patient/visitor complaints and doing so in a timely and empathetic manner. Collaborates throughout the organization to help build a culture committed to our vision of improving the patient experience, patient-centered care and a culture of respect.

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, an

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