Hospital Complaint Reviewer (Onsite Investigator)

GENERAL RESPONSIBILITIES:

This individual is primarily responsible for conducting investigations of hospital, ambulatory surgery center, ESRD and other clinical settings complaints. Responsibilities include but are not limited to conducting onsite reviews.

JOB DUTIES:

1. Conducts onsite/offsite investigations of complaints received.

1. Completes all required documentation.

1. Track all investigative findings in computer system.

1. Prepare and send Statements of Deficiency to provider.

1. Review and accept Plans of Corrections from providers.

1. Responsible for all necessary case processing and maintenance of case specific files.

1. Assists in assessing cases in regard to need for systemic provider/physician quality improvement as a result of complaint.

1. Participates in team meetings, goal setting and reporting activities as directed.

1. Performs such other patient safety and protection activities as may be necessary.

JOB QUALIFICATIONS:

1. Knowledge of state and federal regulatory requirements and experience handling sensitive confidential information.

1. Strong interpersonal skills are desirable to facilitate positive customer satisfaction in situations that are sensitive in nature.

1. Excellent telephone and written communication and assessment skills.

1. Ability to work independently with minimal supervision.

1. Ability to relate effectively to patients/families, providers, and administrative personnel.

1. Ability to travel, required.

EDUCATION & EXPERIENCE:

1. NYS Licensed RN and a graduate of an approved, registered professional nursing program, required. A Bachelor’s degree in Nursing, preferred.

1. A minimum of two (2) years of recent, clinical experience in various provider settings, required.

1. Supervisory experience, a plus.