Kaiser Permanente Ombudsman/Mediator in Harbor City, California
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.
COMPANY Kaiser Permanente
LOCATION Harbor City, CA