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complaint and investigation specialist resume example with 16+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary

Dedicated, extremely professional, and highly organized patients rights advocate with excellent interpersonal skills in counseling, listening, and advising in crisis situations.

Enthusiastic, committed, resourceful, and dependable.

Strong conflict resolution and excellent communication skills.

Goal-oriented individual with a pleasant personality and a history of being a very effective team member with a full understanding of the underwriting process and team needs. Excellent at juggling multiple tasks and working under pressure. Very organized and structured, at the same time being very flexible and genuine. Knowledgeable patient representative offers demonstrated skills in case management and service coordination. Expertly handles complaints, inquiries and service questions to meet patients' access needs and correct problems related to care. Well-versed in policies, procedures and standards.

Skills
  • Knowledge of Welfare and Institutions Code 5328 regarding the confidentiality of clients’ private information. ·
  • Strong attention to detail and Ability to work as a team member with minimal supervision. · Demonstrate Responsiveness and Sensitivity to complex and changing situations ·
  • Ability to analyze facts and arrive at a conclusion based on knowable facts.
  • Solid written and verbal communication skills · Adhere to agency and county confidentiality policies and federal HIPAA standards and Ability to work courteously with people from diverse cultures and identity Client assessment and analysis
  • Extremely organized, excellent personal skills, and conflict resolution skills.
  • Enthusiastic, Commitment, and resourceful Ability to work well as a team and independently
  • Ability to handle highly stressful situations with professional approach
  • Proactive problem solving
  • Legal compliance
  • Patient interviewing skills
  • Training & Development,Team management
  • Personable nature
Experience
Complaint and Investigation Specialist, 08/2022 to Current
Mental Health Association Of Alameda CountyCity, STATE,
  • Works to resolve complaints at the lowest level possible by working with all related parties.
  • Brings recommendations of corrective action to internal program management.
  • Completes investigation reports within.
  • As needed, engages in investigative activities inclusive of interviews and record reviews and required timelines. Maintains investigation files.
  • Provides education and consultation to mental health providers related to patients’ rights, 5150
  • Requirements and other mental health statutes. Knowledge of California Code of Regulations, Title 9, 865.2, Denial of Rights, Good Cause, 865.3 Documentation of reason for denial of rights.
  • Knowledge of Welfare and Institutional Code 5325 and 5325.1, Legal and Civil Rights of Persons
  • Involuntarily Detained. Works to resolve complaints at the lowest level possible by working with all related parties. As needed, engages in investigative activities inclusive of interviews and record reviews and draw conclusions based on evidence to make a determination relative to the substantiation of complaints.
  • Brings recommendations of corrective action to internal program management. Completes investigation reports within required timelines. Maintains investigation files.
  • Provides education and consultation to mental health providers related to patients’ rights, 5150 requirements and other mental health statutes. Knowledge of California Code of Regulations, Title 9, 865.2, Denial of Rights, Good Cause, 865.3 Documentation of reason for denial of rights. Knowledge of Welfare and Institutional Code 5325 and 5325.1, Legal and Civil Rights of Persons Involuntarily Detained.
Patients Rights Advocate, 01/2011 to Current
Mental Health Association Of Alameda CountyCity, STATE,

Advise clients of their rights, interview and, represent them in hearings. Receive and investigate complaints regarding abuse/neglect, punitive, and unreasonable denial of patients rights. Provide training, educating, and facilitating Patient's Rights issues to patients, and Staff.

Monitoring facility programs and services for compliance with patients' rights law, regulations and procedures

  • Provided knowledgeable and compassionate service in response to all types of patient questions and concerns.
  • Managed database of patient information and frequently used computerized systems to track details.
  • Assisted patients in selecting appropriate courses of actions and obtaining needed support.
  • Addressed patients' complaints-head on, investigated concerns and worked with medical staff to devise solutions.
  • Received patient inquiries or complaints and directed to appropriate medical staff members.
  • Trained facility volunteers on guest relations procedures and patients' rights.
Duel Diagnosis Case Manager Housing Coordinator, 06/2008 to 08/2010
Ocean Park Community CenterCity, STATE,

Outreach for clients, and working extensively with homeless population in Santa Monica area. Responsible for conducting psycho-social assessment and developing an appropriate action plan to support the client in achieving their goal. Accompany clients to appointments, treatment programs and other essential services once a month, or as needed. Assist clients in obtaining financial assistance from government programs such as SSI, SSDI, and general assistance. Help clients by facilitating referrals to emergency shelter and transition housing, as well as collaborating with the process to obtain permanent housing.

  • Reviewed casework documentation for accuracy, clarity, detail and objectivity relevant to caseload.
  • Discussed client advocacy and referral services, supporting families with education and resources.
  • Reviewed social service and case management plans to guide implementation.
  • Coordinated resources from diverse providers for intervention plans.
  • Optimized program resource utilization to prevent unnecessary hospital admissions.
Patients Rights Advocate , 12/2004 to 12/2007
Mental Health Association Of Alameda CountyCity, STATE,

Provide training and education to hospital faculty with regard to patients legal rights. Make referrals to other programs and facilities as needed. Conduct capacity hearings and represent patients with regard to medication intake and understanding the risks and benefits of refusing medication. Consult clients via telephone calls, in person when client in crisis, and effectively answered questions and inquiries.

  • Provided knowledgeable and compassionate service in response to all types of patient questions and concerns.
  • Assisted patients in selecting appropriate courses of actions and obtaining needed support.
  • Liaised with staff from diverse hospital departments to bring about effective resolutions to range of issues.
  • Acted as liaison for hospital staff, physicians, patients and family members.
  • Addressed patients' complaints-head on, investigated concerns and worked with medical staff to devise solutions.
  • Facilitated communication between patients, medical and administrative staff, administrative staff and regulatory agencies.
  • Trained facility volunteers on guest relations procedures and patients' rights.
  • Received patient inquiries or complaints and directed to appropriate medical staff members.
Education and Training
Bachelor of Arts: General Management , Expected in 1999
Rajabhat Mahasarakham University - Mahasarakham, Thailand.
GPA:
Certifications

Mental Health Rehabilitation Specialist

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Resume Overview

School Attended

  • Rajabhat Mahasarakham University

Job Titles Held:

  • Complaint and Investigation Specialist
  • Patients Rights Advocate
  • Duel Diagnosis Case Manager Housing Coordinator
  • Patients Rights Advocate

Degrees

  • Bachelor of Arts

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