Registered Nurse Grievances & Appeals Specialist

We are so glad you are interested in joining Sutter Health!

Organization:

PAMF-Palo Alto Medical Foundation PAD

Position Overview:

The Experience of Care Specialist (RN) supports the patient and family experience by addressing questions and offering information, in support of patient-focused clinical services. Serves as liaison between patient and hospital staff while functioning as a patient advocate interfacing with patients, families, staff and hospital administration; assists patients in interpreting hospital policies, procedures and services, and in obtaining solutions to problems and concerns. Problems encountered are often clinical in nature and of a high level of complexity requiring a great deal of innovation. Collaborates closely with managers, physicians and staff throughout the organization. Collaboration across Administration, Quality, Legal and Risk Management Services is required on a frequent basis for complex medical legal issues. Assists staff members who request intervention in diffusing difficult or volatile patient situations.

Job Description:

EDUCATION:

• Graduate of an accredited school of nursing

CERTIFICATION & LICENSURE:

• RN-Registered Nurse of California
• BLS-Basic Life Support Healthcare Provider

TYPICAL EXPERIENCE:

• Two years recent relevant experience

SKILLS AND KNOWLEDGE:

Thorough knowledge of National Patient Safety Goals, ECRI, Occupational Safety and Health Administration (OSHA) standards.

Thorough knowledge process improvement tools including meeting management, data collection/analysis, trending, report/letter writing, targeted education and presentation skills.

Ability to effectively and accurately complete investigation of occurrence reports, soliciting leadership involvement, team building, assisting with learning activities.

Ability to conduct a thorough and credible intense analysis to ascertain proximal causes of adverse events or near misses.

Ability to manager patient grievances to protect patient rights, identify opportunities for improvement, and reduce potential exposure.

The Joint Commission, Title 22 and (Center for Medicare and Medicaid Services) CMS requirements and standards such as performance improvement, patient safety, and grievance management.

Local, State and Federal laws / regulations pertaining to acute care hospital risk management.

The principles and practices of accident prevention, including knowledge of basic State and Federal occupational safety and health regulations.





 

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Monday - Friday

Weekend Requirements:

None

Benefits:

Yes

Unions:

No

Position Status:

Non-Exempt

Weekly Hours:

40

Employee Status:

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $82.57 to $108.99 / hour

The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.