Job Code: SEM-14365
- Day shift
Risk Manager, 40 HRs/Week, Day Shift, Varied Schedule, Weekends As Needed
· Under the general supervision of the Manager/Director of Quality & Patient Safety, with latitude for independent initiative and judgment, the Risk Manager is responsible for coordinating all aspects of the risk management program, including the identification, evaluation and treatment of risk in the organization. The risk manager develops and manages a systematic process to identify, assess, and treat actual and potential exposures to loss.
· Assists the Manager/Director of Quality & Patient Safety with the implementation of the System-wide Quality and Safety Plan consistent with board approved plans and regulatory and standard setting agencies.
· Oversees activities of the Patient Advocate and Human Rights Officer to ensure compliance with reporting obligations as defined by regulating bodies.
· The Risk Manager is directly accountable to the Manager/Director of Quality & Patient Safety, as well as, the System Sr. Director of Risk Management & Patient Safety and Vice President of Medical Affairs.
· Forty (40) hours per week. Occasional travel off-site required.
· Manages a risk identification process for the organization's operations, departments, and services. Educates and assists other managers in assessing their areas of responsibility for exposures to loss and unsafe processes and conditions.
· Maintains a risk management information system. Collects, evaluates, and reports on events, incidents, and claims. Performs statistical analysis and trending of events and claims to pinpoint high risk areas for management attention.
· Reviews and analyzes incident reports, rates by severity and conducts all follow-up as identified from review. Completes trending analysis to identify top priority areas for improvement
· Investigates all serious events. Assists with communication and documentation of errors or serious events in accordance with legal requirements and/or accreditation standards.
· Develops and maintains positive working relationships with providers, management, and staff to promote open communication and accurate flow of information.
· Coordinates risk and safety management orientation and continuing education programs for providers, management, and staff to enhance awareness of their role in patient safety, risk reduction, and event reporting.
· Chairs the patient safety triage team/grievance committee(s) and serves on other patient care and safety related committees as member, or ex officio, as needed to communicate findings, recommendations, actions, and results.
· Acts as liaison to outside agencies such as local, state, federal, or voluntary accrediting agencies.
· Prepares reports of events as required by law or in accordance with voluntary participation.
· Coordinates internal surveys and inspections, monitors reports, and coordinates corrective actions or recommended improvements with management and staff.
· Remains knowledgeable about and promotes compliance with professional standards and guidelines. Implements changes to ensure consistency with regulatory requirements.
· Works with general counsel to coordinate the investigation, processing, settlement, and defense of claims and suits against the organization. Notifies insurance carriers of potential and actual claims. Coordinates the release of information in response to subpoenas, court orders, attorney requests, etc.
· Reviews patient complaints which may result in legal action. Works with patient advocate to offer solutions to patient grievances. Works with billing and compliance officer in deciding on appropriateness of billing waivers/write offs.
· Assists departments with the integration of quality, regulatory, infection control and risk management activities.
· Supports process of root cause analysis in the event of a sentinel or near miss event. Coordinates review of medical information, debriefs all individuals as identified, performs cause and effect analysis and coordinates expert panel review, root solution and follow-up for all incidents identified
· Supports FMEA analysis when high volume, high risk opportunities as discovered through incident report analysis. Organizes team, creates process maps, creates failure modes analysis, identifies prevention and/or corrective action strategies and implants as identified
· Understanding and implementation of programs related to national and local patient safety initiatives
· Acts as liaison to statewide and national collaborative for quality and safety initiatives
· Available by beeper at all times, during scheduled working hours.
· Shall be accountable for maintaining the confidentiality and security of all hospital-related, medical staff-related and patient-related data and information.
· Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
· Commits to recognize and respect cultural diversity for all customers (internal and external).
· Communicates effectively with internal and external customers with respect of differences in cultures, values, beliefs and ages, utilizing interpreters when needed.
· Performs other duties as assigned.
REQUIRED KNOWLEDGE & SKILLS:
· Strong organizational skills.
· Strong interpersonal skills, ability to work across disciplines.
· Ability to analyze data and formulate meaningful information.
· Ability to work with, develop, and motivate multidisciplinary teams.
· Strong orientation to patient care in accordance with the Medical Center's values.
· Ability to work with highly sensitive and confidential information, with appropriate discretion.
· Able to communicate verbally and in writing in the English language.
- Education: Clinical background to provide for appropriate investigation of clinical events; RN, preferred; Bachelor's Degree, required; MS or JD, preferred
- Experience (Type & Length): Minimum of 2-5 years in a hospital risk management with a focus on patient safety, risk management or quality improvement. Experience and/or demonstrated understanding of root cause analysis, FMEA analysis, improvement methodology, concepts, education and implementation. Working knowledge of LEAN, TJC, DPH & CMS regulations.
- Certification/Licensure: Training in patient safety or risk management and quality performance, required; Certification Professional in Healthcare Risk Management (CPHRM), preferred; membership and active participation in professional organization(s), preferred.
IV. Software/Hardware: Working knowledge of Microsoft Office required. Knowledge of rlSolutions, MCN Policy Manager, and Meditech preferred.