Job Description

Patient Representative

Location: San Diego, CA Job Number: 907192 Date posted: 12/09/2020 Submit Interest Add to Favorites Remove from Favorites

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Description: Facilitates the optimal use of the Kaiser Permanente ambulatory care system by members who are experiencing difficulties. Facilitates the improvement in the quality of care and service provided. Assists with the integration of new members. Identifies and corrects, to the extent possible, conditions and/or activities that are potential sources of organizational liability.
Essential Functions:
- Provides ombudsman service between members, providers and the Kaiser Permanente system to facilitate optimal use of member care services.
- Promotes member satisfaction by providing timely and sensitive intervention and resolution of problems.
- This includes providing advice, making appointments, assigning primary care physicians and physician changes.
- Handles complaints and problems in such a way as to diffuse anger and frustration and improve the member's perception of the care and service.
- Develops policies, procedures and protocols, in conjunction with appropriate departments, to effectively handle member complaints and problems.
- Reviews policies and procedures and makes recommendations for change with respect to decreasing risk/liability and improving member care and service.
- Negotiates mutually acceptable solutions to compensable events (within guidelines acceptable to the Medical Group and KFHP).
- Develops and implements tracking systems and feedback mechanisms for administration staff and physicians so that complaints and problems can be used to improve services provided.
- Uses information from complaints, identified problems, and incident reports to develop and implement methods to reduce risk for members and staff and to reduce potential liability for the organization.
- Identifies systems problems and works with managers to effect appropriate change. Basic Qualifications:
Experience
- Minimum three (3) years of KP organizational experience in a direct ambulatory care environment or minimum three (3) years in membership services.
Education
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A
Additional Requirements:
- Demonstrated ability to interview, investigate, and counsel effectively.
- Demonstrated ability to deal with hostile crisis situation with a level of sensitivity and understanding.
- Demonstrated good analytical skills and the ability to problem solve creatively, objectively, and rapidly.
- Ability to educate staff and physicians on risk management and quality improvement issues.
- Computer literacy.
- Must be able to work in a Labor-Management Partnership environment.

Preferred Qualifications:
- Bachelor's degree preferred. Primary Location: California,San Diego,San Diego Medical Center 9455 Clairemont Mesa Blvd Scheduled Weekly Hours: 0 Shift: Variable Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun Working Hours Start: Variable Working Hours End: Variable Job Schedule: Per Diem Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Non-Union, Non-Exempt Job Level: Individual Contributor Job Category: Customer Services Department: Guest Services Travel: Yes, 25 % of the Time 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.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
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