Health Care Ombudsman Mediator Specialist VI (KFHP/H)

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 health care disputes early 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:

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; provides actionable feedback to others, including upward feedback to leadership; influences, mentors, and coaches team members. Practices self-leadership; creates, evaluates, and responds to the strengths and weaknesses of self and unit or team members. Leads the adaptation to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Fosters open dialogue amongst team members.
• Drives the execution of multiple work streams by identifying member and operational needs; translates business strategy into actionable business requirements; develops and updates new procedures and policies. Gains cross-functional support for objectives and priorities; determines and carries out processes and methodologies; solves highly complex issues; escalates and resolves issues as appropriate; sets standards and measures progress. Develops work plans to meet business priorities and deadlines; coordinates, obtains and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; influences the completion of project tasks by others.
• Facilitates a fair, open, and creative atmosphere by: ensuring effective communication and collaboration with key stakeholders at all levels of the organization, including reporting to leaders at the highest levels (e.g., Senior Vice Presidents, Chief Operating Officers, Area Medical Directors, Executive Legal Attorneys); maintaining strict confidentiality and discretion and serving as a role model emphasizing the importance of confidentiality to all stakeholders (e.g., patients, physicians, executives, KP staff); fostering trusting relationships and acting as a champion for the diverse and complex needs of stakeholders across the organizational landscape; developing collaborative relationships within the Medical Centers, Local, Regional, and National departments and working with stakeholders across all levels of the organization (including those at the highest levels) in order to resolve conflicts, and address highly emotional situations; fostering strategic partnerships with senior and executive leadership to consult and influence the development and refinement of key priorities and strategy; and initiating contact with other appropriate Local, Regional, Legal, and/or National departments as necessary (e.g., Risk, Quality).
• Serves as a conflict resolution expert following unanticipated adverse medical outcomes by: sharing successful practices and disseminating learning in collaboration with Local, Regional, and National Patient Safety and Risk Management functions; leveraging a deep understanding and comprehension of complex clinical and medical information to effectively assess and identify potential issues or conflicts (e.g., staff/provider rounds, communicating with health care teams and/or administration to ensure adverse medical outcomes of care are addressed); receiving referrals for conflict resolution and evaluating the appropriate method of resolution (e.g., shuttle diplomacy, mediation, coaching) and/or referring or escalating to appropriate department(s); deescalating highly complex, sensitive, and emotionally charged situations; working with key stakeholders to facilitate conflict resolution for executive leadership (e.g., Kaiser Foundation Health Plans, Permanente Medical Group) across all levels of the organization, locally, regionally and nationally; and acting as a consultant on physician disclosure discussions and complex patient case scenarios.
• Mediates physician/provider/patient conflict following unanticipated adverse medical outcomes by: facilitating communication between disputing parties; practicing narrative mediation which seeks to identify unique narratives each party holds related to a conflict; investigating issues thoroughly and impartially by gathering information and conducting informal fact-finding to understand the context of the dispute, assess the gravity of the situation, and address the concerns presented by all sides; identifying issues to allow parties to hear and understand one anothers perspectives and demonstrating empathy to assist in finding common ground between disputing parties; assisting parties in externalizing conflict to allow for greater constructive dialogue, while encouraging understanding and empathy towards one another; preparing all parties and facilitating protected, confidential, and privileged mediations; effectively translating and communicating complex medical information to stakeholders ensuring a high level of accuracy and clarity in order to facilitate decision-making and problem-solving in the dispute resolution processes; and remaining neutral, making independent recommendations, and assisting parties in identifying potential solutions to resolve their conflict.
• Supports education, training, and continuous organizational awareness related to the HealthCare Ombuds/Mediator (HCOM) program by: developing and implementing ongoing communications, programs, educational events, training, program awareness, and supporting materials (e.g., informational materials, videos, brochures); leveraging deep subject matter expertise to create and conduct trainings (e.g., on communication skills, communicating unanticipated adverse outcomes) for individuals and groups (administrative and clinical); serving as a consultant regarding conflict resolution for the development of provider, physician and leadership communication and education programs across KP; and acting as a trusted senior advisor to provide coaching and guidance to key stakeholders, providers, and executive leadership regarding complex issues (e.g., communication, dispute resolution strategies).
• Ensures the continued success of the HealthCare Ombuds/Mediator (HCOM) program by: developing and maintaining HCOM program in coordination with the HCOM Executive Sponsorship Committee (HESC), including charter, guidelines, HCOM goals, and promotional materials; facilitating and participating in a self-governance model (e.g., rotational leadership team, work groups, peer support, mentoring); establishing and maintaining an internal network of HCOM professionals to foster ongoing program improvement and development; working with senior and executive leadership within the organization, including hospital, health plan, and physician groups to promote and integrate the HCOM program locally, regionally, and nationally; and upholding the HCOM program core principles of neutrality, independence, confidentiality, and informality.
• Supports identification of patient safety, risk, and/or quality trends by: utilizing expert knowledge to identify patterns, trends, and systemic issues affecting patient care by analyzing patient, provider, and senior and executive leader concerns; providing insights and feedback based on identified patterns and trends to senior and executive management at the local, regional, and national levels; and proactively and persuasively driving identification and communication of patterns, trends, and systemic issues to senior and executive leadership, both across and upward in the organization.