Client Affairs, Research & Resolution Officer (GMG/SEG 2)

Summary

Reporting to the Director Client Affairs, Research & Resolution, the Client Affairs, Research & Resolution Officer is responsible for furthering the investigation of escalated complaints and facilitating resolution. The Officer leads the analysis of complaints and investigation data on breaches of professional standards within the Jamaican Public Health System. The incumbent identifies patterns, utilizes systematic reporting to address clinical and non-clinical complaints, and ensures compliance with healthcare regulations. The Officer plays a key role in improving healthcare quality through the thorough review and analysis of health policies, legislative frameworks, and standards. By providing detailed insights and strategic recommendations, the incumbent drives the ongoing enhancement of health and wellness policies, programmes, and practices. 💰Salary: $4,266,270 JMD per annum.

Responsibilities

• Key Outputs:

  • • Investigation and resolution of escalated nonclinical complaints completed.
  • • Comprehensive documentation and analysis of investigation findings documented.
  • • Client Affairs Resolution (CAR) procedures and tools disseminated.
  • • Client Affairs Resolution Compliance Audit Reports of BPO, RHA and Departments and attendant improvement plans documented.
  • • Improvement and intervention programmes implemented.
  • • Relationships with internal and external stakeholders developed and maintained.
  • • Policy advice and technical information provided.
  • • Client satisfaction with case management determined and reported.
  • • Client feedback and case outcomes reviewed, analyzed and reported.
  • • Quarterly, annual periodic statistical of client feedback and case resolution data reports prepared.
  • • Continuous service improvement data and insights documented.
  • • Individual workplan prepared.
  • • Monthly Performance Reports submitted.
• Management / Administrative:

  • • Formulate reports for Director, Client Affairs, Research & Resolution, highlighting patterns, recommending changes, and informing policy development.
  • • Maintains communication with professional councils, associations, and legal services to support investigations, case reviews and resolution of all complaints escalated to the Unit for further management.
  • • Liaises with legal, policy and people-centred specialists to address and resolve health related people-centred challenges.
  • • Maintains comprehensive case files with relevant documentation to support evidence of cases management and resolution.
  • • Maintains contact with partners and stakeholders to support the collaborative approach to addressing public policy breaches and gaps in healthcare service standards.
  • • Maintain contact with stakeholders to ensure that assistance and advice are attended to, as agreed, and in a timely manner and timely reports any potential risks or issues.
  • • Prepares timely reports for stakeholders, including weekly and monthly updates for the Director.
  • • Oversees processing and submission of fines, ensuring accurate financial records and reporting.
  • • Conducts frequent analysis of clinical complaint data; with special emphasis on serious clinical complaints with the view of identifying trends, areas of clinical care warranting special attention and focus – audits, policy review or protocols to govern them.
  • • Collaborates with internal teams to ensure a seamless client service experience.
  • • Maintains records and documentation related to technical activities.
  • • Contributes to the development of Operational / Work Plans for Enabling Environment in Health and Client Affairs.
  • • Contributes to the preparation of budget.
• Technical Responsibilities:

  • • Receives, authenticates, records client feedback and notification of case updates from the relevant authorities within the RHA, Department and MOHW regarding service delivery in the database.
  • • Acknowledges receipt of client feedback or notification of case management received by the Unit.
  • • Examines the nature of client feedback, including complaints, concerns, suggestions and request for general assistance received by the Unit for appropriate classification.
  • • Assesses all types of client feedback received in order to determine the basis for referral the referral pathway and refers the case appropriately to initiate the necessary investigations and case resolution.
  • • Liaises with local complaint leads or customer care leads in the Departments, MOHW, RHAs to provide support and facilitate local resolution as appropriate.
  • • Conduct technical investigations of the potential breaches in the delivery of health services within RHA, Department and MOHW for cases escalated or those otherwise assigned.
  • • Leverages specialized knowledge in relevant fields (e.g., clinical care, medication management, drug pharmacokinetics, meal planning, etc.) to interpret and analyze evidence, identifying patterns and systemic failures in healthcare service delivery.
  • • Adapts investigation approaches based on new evidence and evolving scenarios.
  • • Implements creative approaches to navigate complex or novel challenges in investigations and develops and manages comprehensive investigation plans, meticulously gathering evidence and analyzing data.
  • • Reviews medical records and reports related to claims of medical negligence to verify completeness of investigation, to facilitate submission to the Medical Review Panel (MRP).
  • • Presents cases to the Client Affairs Resolution Committees to facilitate the review of their management and determine of the resolution options for those escalated from the Departments, and MOHW.
  • • Undertakes root cause analysis on issues identified from case escalated for further management to support the closure of case management.
  • • Conducts assessment into the Ministry’s existing health standards, policies, guidelines and related legislation to determine levels of adherence to these requirements, gaps in policies and other factors that contribute to systemic issues.
  • • Contributes to the conduct of research related to quality issues identified from complaint investigations and outcomes and documents findings for inclusion in the service delivery improvement plans and the case status reports.
  • • Prepares formal reports with actionable recommendations for legal proceedings, policy changes, and improved healthcare standards.
  • • Works closely with the Senior Client Affairs, Research & Resolution Officers to conduct compliance audits within the Departments, MOHW, RHAs and other service delivery points.
  • • Conducts case closure for escalated complaints and submits the case status reports for review and finalization.
  • • Undertakes case management satisfaction, analyses the data, communicates the results, making recommendations for improvement in the client affairs resolutions system.
  • • Tracks the implementation of recommendations from compliance audits and service improvement plans and case status reports on the status of implementation.
  • • Works alongside the Senior Client Affairs, Research & Resolution Officers to develop and facilitate training programs for relevant stakeholders to build awareness on client affairs resolution mechanism.
  • • Conducted scheduled training sessions in RHAs, Departments, MOHW, and other service delivery points, to effectively build capacity and knowledge on client affairs resolution management procedures.
  • • Contributes to identifying potential risks and the necessary controls to mitigate the resultant effect on the achievement of strategic objective, operational targets and improvement initiatives.
  • • Contributes to significant decisions regarding legal actions and prevention of systemic issues in healthcare services.
  • • Prepares comprehensive reports with documented findings and analysis on a monthly, quarterly, and annual basis.
  • • Promote compliance with stipulated procedures, policies and legislation.
  • • Prioritize tasks, allocate resources effectively, and ensure seamless collaboration across teams.
• Performance Standards:

  • • Complaints and breaches are resolved in accordance with established standards.
  • • Standard reports (Including recommendations) submitted within schedule.
  • • Improvements in healthcare quality and increase client satisfaction based on surveys post-resolution of complaints to measure impact.
  • • Conduct training sessions in RHAs and assigned entities according to schedule.
  • • CAR Compliance Audit Conducted according to schedule.
  • • Positive impact on healthcare quality and client satisfaction.
  • • Attends training in legal and ethical standards in investigations.
  • • Client Affairs Resolution mechanism updated, monitored and maintained.
  • • Analyze trends in complaints to identify areas for cost reduction and quality improvement.
  • • Implement changes and measure impact through pre and post-analysis.
  • • Review complaints to inform policy and process recommendations.
  • • Complaints are resolved based on established key performance indicators.
  • • The Complaints mechanism informs quality improvement activities.
  • • Review process efficiency and make adjustments to ensure consistent meetings of deadlines.

Preferred Qualifications

• ★ Bachelor’s degree in healthcare management, Health-Related Science, Public Health or equivalent qualifications.
• ★ Three (3) years’ experience as a healthcare professional post registration.
• ★ Training/Experience scientific research/investigation is required.
• OR
• ★ Bachelor’s degree in nursing/health service management/public Sector Administration/Business Administration/Human Resource Management and minimum of three (3) years’ experience working in a customer service environment or monitoring quality of service provision and delivery.

Additional Information and Instructions