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Ombudsman\Mediator Bellflower, CA



Description

The HealthCare Ombudsman/Mediator functions as a trained alternative dispute professional offering patients, family members, staff & providers a conflict management program to resolve patient/ provider healthcare disputes early & quickly thereby improving patient safety & reducing the costs of health care dispute resolution. Serves as a trusted & informal information resource, communication channel, complaint handler, facilitator, consultant & practitioner for dispute resolution. Acts to seek fair & equitable solutions to patient/provider problems & for suggesting dispute resolution processes for addressing & managing conflicts & for policy & procedural changes. Brings issues to senior leadership to address care delivery improvement efforts. Promotes effective relationships/communication between patients & providers.

Essential Functions:
- Program Implementation: Implements the healthcare ombudsman/mediator (HCOM) program.
- Establishes annual work plan & performance metrics to demonstrate program effectiveness, including but not limited to: patient & provider satisfaction, cost savings, cost avoidance in lawsuits averted, increased productivity, savings in management time, increased personnel resources & the promotion of patient safety initiatives.
- Develops & implements an on-going communications program, including informational materials for patients & family, staff training & awareness building & materials for external audiences.
- Patient/Provider/Staff Ombudsman/ Mediator Process: Serves as a dispute resolution practitioner whose major function is to provide confidential & informal assistance to patients & providers in resolving patient care issues, which includes the following.
- Receives inquiries for dispute resolution, listens impartially & questions the patient/staff to help put the problem into perspective.
- Conducts informal fact-finding & gathers information, including any general background information that may be helpful to understand the overall context of the dispute & assesses the overall gravity of the situation, & meets w/ the parties to discuss issues.
- Based on an analysis of the situation, recommends options to assist the parties in the resolution of their dispute.
- Serves as an impartial & independent third party for clients, focusing upon patient care issues.
- Facilitates contact w/ other appropriate local/regional departments as necessary (e.g. Legal or Member Services) Collaboration & Problem Solving: Develops collaborative relationships w within the Medical Center & Regional departments to provide & facilitate a fair, open & creative atmosphere.
- Provides feedback to senior management by tracking & analyzing types of patient & provider concerns,& in collaboration w/ appropriate stakeholder groups.
- Identifies opportunities for improvement to policies & practices which contribute to systemic conflicts, concerns & complaints.
- Provides internal consulting services to providers on communication & dispute resolution strategies, designed to improve individual & organizational effectiveness.
- Analysis & Reporting: Maintains data set to support the evaluation of the effectiveness of the program.
- Analyzes aggregate data/information from HCOM case experience concerning patterns of complaints.
- Identifies & informs upper management of patterns & trends affecting patient care.
- Knowledge Management: Actively participates w/in the KP patient safety/risk management community, by sharing successful practices & disseminating learning's (in collaboration w/ Regional & National Risk Management functions).
- This job description is not all encompassing.


Qualifications:

Basic Qualifications:
Experience
- Minimum ten (10) years of clinical or hospital/healthcare background required.
Education
- Bachelor's degree required.
- Evidence of having taken and passed a forty (40) or more hour Ombudsman training course or minimum of 100 cases experience or take and pass a 40 hour or more Ombudsman training course within the first 90 days of employment.
- Evidence of having taken and passed a forty (40) or more hour Mediation course or minimum of 100 cases experience or take and pass a 40 or more hour Mediation training course within the first 90 days of employment.
License, Certification, Registration
- N/A

Additional Requirements:
- Knowledge of relevant healthcare regulations (including HIPAA), accreditory standards, Ombudsman&Mediator Code of Ethics and state tort system (as it relates to medical malpractice).
- Demonstrated ability to work with difficult situations with multiple interests/parties involved.
- Demonstrated analytical/data management skills.
- Demonstrated program development expertise (strategic direction, work planning, communications, implementation).
- Demonstrated excellent written and presentation communication skills.
- Demonstrated expertise in interpersonal skills, including active listening and relationship/trust/consensus building.
- Flexibility to travel to various KP and/or contracted facilities within the coverage area, as applicable, to conduct HCOM responsibilities.
- Flexibility to travel to various locations across the program for training, advanced training, workshops, and presentations.
- Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:
- Minimum ten (10) years of experience in clinical or management roles in a health plan or multi-faceted health care system desired.
- Master's degree in business, health care, public administration or related field desired.
- Knowledge of KP preferred.

Notes:
-Days and hours will vary depending on the needs of the Medical Center.
-Will be required to travel as needed


Primary Location: California,Bellflower,Downey Medical Center

Scheduled Hours (1-40): 40

Shift: Day

Working Days: Mon, Tue, Wed, Thu, Fri, Sat, Sun, Variuable

Schedule: Full-time

Job Type: Standard

Employee Status: Regular

Employee Group: Salaried, Non-Union, Exempt

Job Level: Individual Contributor

Job: Healthcare / Hospital Operations

Public Department Name: Hospital Administration


External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.

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