Job Description
Description: Job Summary: The HealthCare Ombudsman/Mediator functions as a trained alternative dispute professional offering patients, family members, staff and providers a conflict management program to resolve patient/ provider healthcare disputes early and quickly thereby improving patient safety and reducing the costs of health care dispute resolution. Serves as a trusted and informal information resource, communication channel, complaint handler, facilitator, consultant and practitioner for dispute resolution. Acts to seek fair and equitable solutions to patient/provider problems and for suggesting dispute resolution processes for addressing and managing conflicts and for policy and procedural changes. Brings issues to senior leadership to address care delivery improvement efforts. Promotes effective relationships/communication between patients and providers.
Essential Responsibilities: - Program Implementation: Implements the healthcare ombudsman/mediator (HCOM) program.
- Establishes annual work plan and performance metrics to demonstrate program effectiveness, including but not limited to: patient and provider satisfaction, cost savings, cost avoidance in lawsuits averted, increased productivity, savings in management time, increased personnel resources and the promotion of patient safety initiatives.
- Develops and implements an on-going communications program, including informational materials for patients and family, staff training and awareness building and materials for external audiences.
- Patient/Provider/Staff Ombudsman/Mediator Process:
- Serves as a dispute resolution practitioner whose major function is to provide confidential and informal assistance to patients and providers in resolving patient care issues, which includes the following.
- Receives inquiries for dispute resolution, listens impartially and questions the patient/staff to help put the problem into perspective.
- Conducts informal fact-finding and gathers information, including any general background information that may be helpful to understand the overall context of the dispute and assesses the overall gravity of the situation, and meets with 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 and independent third party for clients, focusing upon patient care issues.
- Facilitates contact with other appropriate local/regional departments as necessary (e.g. Legal or Member Services).
- Collaboration and Problem Solving:
- Develops collaborative relationships within the Medical Center and Regional departments to provide and facilitate a fair, open and creative atmosphere.
- Provides feedback to senior management by tracking and analyzing types of patient and provider concerns, and in collaboration with appropriate stakeholder groups.
- Identifies opportunities for improvement to policies and practices which contribute to systemic conflicts, concerns and complaints.
- Provides internal consulting services to providers on communication and dispute resolution strategies, designed to improve individual and organizational effectiveness.
- Analysis and 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 and informs upper management of patterns and trends affecting patient care.
- Knowledge Management:
- Actively participates within the KP patient safety/risk management community, by sharing successful practices and disseminating learnings (in collaboration with Regional and National Risk Management functions).
- Establishes and maintains external network of Ombudsman professionals to foster on-g oing program improvement and up-to-date information.
Basic Qualifications: Experience
- Minimum ten (10) years of clinical or hospital/healthcare background required.
Education
- Bachelors 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
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.
- Knowledge of KP preferred.
- Masters degree in business, health care, public administration or related field desired.
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Primary Location: California,Los Angeles,West Los Angeles Medical Center
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri,
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Onsite
Employee Status: Regular
Employee Group/Union Affiliation: NUE-SCAL-01|NUE|Non Union Employee
Job Level: Individual Contributor
Department: West LA Medical Center - Hospital Administration - 0801
Pay Range: $126800 - $164010 / year Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.
Travel: Yes, 10 % of the Time
On-site: Work location is on-site (KP designated office, medical office building or hospital). Worker location must align with Kaiser Permanente's Authorized States policy. At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:
- Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.
- Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty, shows consistency in words and actions; follows through on commitments.
- Job duties with at least occasional or possible access to: (1) patients, the general public, or other employees; (2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (4) controlled substances regulated by federal law or potentially subject to diversion.
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Job Tags
Full time, Work experience placement, Local area, Shift work,