Patient Representative
Primary Location Santa Ana, California
Worker Location Onsite
Facility Harbor/MacArthur Medical Offices
Job Number 1349004 Date posted 05/16/2025
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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.
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 members 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.
Job Summary:
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 Responsibilities:
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 members 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 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:
- Bachelors degree preferred.
Primary Location: California,Santa Ana,Harbor/MacArthur Medical Offices
Scheduled Weekly Hours: 40
Shift: Evening
Workdays: Sun, Mon, Tue, Wed, Thu, Fri, Sat
Working Hours Start: 11:30 AM
Working Hours End: 08:00 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Onsite
Employee Status: Regular
Employee Group/Union Affiliation: NUE-SCAL-01|NUE|Non Union Employee
Job Level: Individual Contributor
Department: Harbor-Macarthur MOB - Radiology-Clerical - 0806
Pay Range: $25 - $32.31 / hour
Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.
Travel: No
On-site: Work location is on-site (KP designated office, medical office building or hospital).
Worker location must align with Kaiser Permanente's Authorized States policy.
At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.
For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:
Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.
Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty, shows consistency in words and actions; follows through on commitments.
Job duties with at least occasional or possible access to: (1) patients, the general public, or other employees; (2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (4) controlled substances regulated by federal law or potentially subject to diversion.
Submit Interest
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.
For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:
