This individual is primarily responsible for working in a centralized complaint intake unit processing hospital, ambulatory surgery center, End-Stage Renal Disease (ESRD) and other clinical setting complaints. Responsibilities include but are not limited to answering telephone calls, responding to executive and/or written correspondence from patients, family representatives, advocates, and health care providers with complaints about care and services at these settings. The nurse will ask questions sufficient to understand the nature of the complaint and its likely impact on patient care and services. Complaint information will be entered into the federal Aspen Complaint Tracking System (ACTS) for review during triage. This individual will participate in Case Review, Triage, CHIP Bureau meetings and perform other activities as directed.
As a result of telephone calls and/or written complaints, communicate with the complainant providing him/her with an explanation of the complaint process and obtain specific details to completely and thoroughly document the actual complaint in.
1.Tracks, monitors and communicates status of assigned complaint investigations.
2. Responsible for case processing and updating of case specific files.
3. Participates in team meetings and reporting activities as directed.
4. Daily use of Microsoft Suite of products (Word, Excel, Access) and federal databases (ASPEN, ACTS).
5. Performs other activities as may be necessary.
1. Knowledge of state and federal regulatory requirements and experience handling sensitive confidential information.
2. Strong interpersonal skills are desirable to facilitate positive customer satisfaction in situations that are sensitive in nature.
3. Excellent telephone and written communication and assessment skills.
4. Ability to work independently with minimal supervision.
5. Ability to relate effectively to patients/families, providers, and administrative personnel.
Licensed as a Registered Professional Nurse in New York State.
Recent clinical experience in various provider settings.
Experience with computers, computer databases, Outlook and Microsoft Office Suite.