Claims Risk Manager Jobs in Illinois (NOW HIRING)

Hourly Pay Range:

Position Highlights:

• Position: Clinical Risk Manager
• Location: Evanston, IL
• Full Time:40 hours/week
• Hours: Monday-Friday,8:00a-5:00p with on call rotation every 6 weeks
• Required Travel: To Endeavor locations: Skokie-Glenview-Highland Park

A Brief Overview:
The Clinical Risk Manager is responsible for the review, investigation and prioritization of reported clinical and organizational events in order to decrease the frequency and severity of patient safety events and works closely with Claims Management to identify potential/actual professional and general liability claims. Colla

borates with Performance Improvement team and Operational Leaders to identify key quality and patient safety trends. Actively engages leaders in evidence-based practice for cause analysis and high reliability strategies to prevent and mitigate patient safety events.
What you will do:

Patient Safety/Risk Management

• Review electronically reported events for inpatient units and procedural areas
• Identify and assess potential risks and liabilities of reported events
• Work with interdisciplinary teams to identify and implement risk mitigation strategies, leaders in associated departments/units to assure swift resolution, identification of key learning elements/strategies and assuring timely action/communication is planned and initiated
• Assure involved department(s) event follow-up is timely and appropriate
• Provide patient safety/risk management support for assigned areas including noted trends and education
• Collaborate with identify key quality and patient safety issues that require broader system review and intervention
• Partner with organizational leaders and frontline staff to improve safety culture and processes
• Educate all levels on the importance of early notification of patient safety events
• Analyze experiential data and report trends to leadership
• Serve as an advisor to physicians and Administration on issues related to disclosure, documentation, and management of untoward outcomes
• Coordinate communication of preventable untoward outcomes to key corporate individuals as per protocol
• Manage in collaboration with physician leadership as part of the peer review process
• Collaborating with clinical and administrative teams to conduct risk assessments.
• Promoting patient safety and error prevention through evidence-based practices.

Patient Safety/Risk Management

• Investigate occurrences to identify Potential Compensable Events (PCEs) and work with Claims Management team to discuss and determine liability and causation
• Work with the Claims Management team to process Notices of Claim (NOCs) for submission to Third Party Administrator (TPA) in a timely manner
• Attend monthly Risk/Claims Management meetings to discuss assigned PCEs and NOCs. Meetings are held at Endeavor Health hospital sites on a rotating basis
• Identify potential insurance claims, including tracking, reporting, and coordinating resolution with the Legal and Insurance attorneys/team
• Develop and implement risk mitigation strategies and programs to reduce the hospital's exposure to liability and financial risks.
• Liaising with insurance providers and legal counsel as needed

Other

• Address and assist the Compliance team with the mitigation of mitigating compliance issues as necessary.
• Analyzing data related to risk management, incidents, and claims to identify trends and areas for improvement.
• Using data to inform risk reduction strategies.
• Providing training and education to clinical, non-clinical, and administrative staff on risk management, patient safety, and legal considerations
• Fostering a culture of risk awareness and safety
• Developing and maintaining effective Work with and provide consultation to emergency preparedness leaders and responding plans to ensure the hospital's readiness for unforeseen events
• Takes call 24/7 on a rotating basis.
• Travel to Endeavor Health hospitals on an as needed basis

What you will need:

• Bachelors Degree Health Administration Required Or
• Bachelors Degree Nursing Required
• 5+ Years Clinical experience And
• 2 Years Patient safety/risk management experience as a specialty or associated with Clinical Leadership responsibilities And
• Experience with Epic and RL Solutions preferred
• Strong communication skills - written and verbal.
• Ability to interact with all levels of the organization confidently and professionally.
• Ability to partner with a wide range of team members, physicians and clinicians.
• Conflict resolution and mediation skills.
• Be flexible and adaptable to changing situations and priorities.
• Ability to develop and present educational programs.
• Strong investigative and analytical skills. Multi-tasking capacity.
• Registered Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Preferred

Benefits for full and part time positions):

• Premium pay for eligible employees
• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, and Vision options
• Tuition Reimbursement
• Free Parking at designated locations
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off
• Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org.

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.