University of Rochester Patient Relations & Asst. Quality Manager - 231818 in Rochester, New York
Patient Relations & Asst. Quality Manager Job ID 231818Location Eastman Dental Center Full/Part Time Full-Time Favorite Job Regular/Temporary Regular Opening
Full Time 40 hours Grade 053 EIOH Office of Qual Imp & CompSchedule
8 AM-5 PMResponsibilities
With general direction and considerable latitude for independent judgment, decision-making and initiative, the Assistant Quality Officer/Patient and Family Relations (PFR) Case Manager performs routine and non-routine duties requiring highly advanced quality and patient family-relations skills and proficiency for the Office for Quality Improvement and Compliance (OQIC) at Eastman Institute for Oral Health (EIOH). Addresses complaints and grievances, and intervenes at the earliest possible opportunity, working with staff to seek resolution. AQO/PFR Case Manager is responsible for numerous aspects of departmental details and duties requiring experience with policies, procedures and practices of a health care facility, or a specific health care service division or in other related similar situations. Additionally, serves as the key individual/liaison between Dental Center Billing Office (DCBO) and works collaboratively to identify opportunities to appeal third-party insurance denials while promoting a case management methodology for complex dental patients who may be involved in several divisional specialties. In this role, has frequent contact with EIOH leadership, Directors, Chairs Faculty and other staff. Consistently models effective work behaviors while exhibiting a mature and professional demeanor.
50% Provides assistance to the Associate Quality & Compliance Officer, and Divisional Administrators, when conducting investigations, and resolutions of patient complaints and grievances. Gives professional attention to the relations between patients/patient families and EIOH staff, counseling both in order to assure the former of timely and appropriate response to their concerns, and to benefit the latter through a sensitive interpretation of patient/family needs and feelings; and through this process, assists in identifying and recommending corrective steps for any recurring problems in providing services to patients and their families. Assists patients/families and staff deal with problematic situations in ways that are consistent with the ICARE Values of UR Medicine. Responds immediately and personally, including referring when appropriate, to all complainants, who have contacted EIOH Administrative Offices, i.e. Director’s Office or OQIC,. Establishes special long-term relationships with patients/families and staff having unique or chronic problems, especially in patient matters in which there is liability potential. Prepares summary reports, as requested, for various meetings of EIOH or UR Medicine such as Quality Improvement or JMQC (Joint Meeting on Quality of Care). Identifies potential liability cases and, after investigation, prepares a case summary for legal staff; at the discretion of legal staff, may continue as the primary contact, since many complainants will not take legal initiative if their concerns are listened to carefully. Works closely with the URMC Patient Experience office in training, implementing and monitoring the use of ICARE values throughout EIOH.
45% Coordinates the review of issues that cross divisional lines; and, as necessary communicates with the patient/family. Works to appropriately identify and document persistent and systematic issues. In collaboration and conjunction with the DCBO, identifies cases or patterns of third-party insurance denials and prepares an appeal for benefit coverage which will lead to increased reimbursement. Categorizes and prepares summary reports related to denied insurance claims when requested. Periodically attends Divisional meetings to identify areas for improvement. Assesses monthly divisional financial reports and investigates, categorizes, and resolves patterns write offs. Works with leadership to identify criteria appropriate for educational discounts and communicates criteria to various divisional leadership.
5% Performs other related duties as assigned.
A caring and empathetic manner and the ability to establish rapport with patients and families. Candidate demonstrates excellent customer service skills. Possesses adequate analytical skills to review financial data and draw conclusions and recommendations for process improvement. Knowledgeable in HIPAA regulations and resources within the UR Medicine community. Possesses proficiency and a moderate level of skill with Microsoft Office, including Outlook, Word, Excel, and PowerPoint.
Bachelor’s degree in a health-related field and three years of related work experience, preferably in an academic medical center or hospital; or an equivalent combination of education and experience. Experience in an administrative or customer service capacity is preferred. Dental experience is a plus.How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled