Healthcare Risk Management Jobs in California (NOW HIRING)

Position Summary:
Under the direct supervision of the Risk Management Director or designee, the Risk and Patient Experience Analyst is responsible to assessing and decreasing risks associated with patient safety incidents, as well as, addressing grievances, appeals and improving patient experience through the risk management investigation process. Assist with development, evaluation, and implementation activities related to improving patient safety and the patient experience.

Essential Functions of the Job:

• Analyze patient safety incidents, complaints, and grievances and develop risk mitigation strategies, proactive performance improvement and educational activities related to patient safety.
• Assemble, coordinate, record and facilitate multi-disciplinary teams to conduct root-cause analysis, gap analysis, failure mode and effect analysis (FMEA), or any other applicable risk management tools used to review patient safety events, new services or organizational risk mitigation strategies.
• Partners with other members of Quality and Risk Management Departments to assure integration of efforts along the continuum of Patient Safety to Risk and Peer Review.
• Prepare case reviews addressing incidents related to possible involuntary disenrollment or voluntary disenrollment with SYH based on patient satisfaction, non-compliance or behaviors.
• Proactively identifies, monitors and summarizes participant satisfaction/complaint trends and reports to the management team on a monthly/quarterly basis.
• Coordinates and participates in resolution of complaints, grievances and appeals based on SYH policies and procedures.
• Tracks all health plan and patient complaints & grievances. Provides timely written response according to regulation standards.
• Assist with education & training for staff on incident reporting, and the complaint/grievance process.
• In collaboration with the risk management leadership team or designee, develop a strategic plan to improve the participant experience through site visits, personal coaching and staff training to ensure service excellence competency of staff to drive participant experience improvement and satisfaction goals.
• Provides support with respect to participant satisfaction and relations/experience initiatives including the following:

1. Meeting at sites that have identified areas of improvement
2. Attendance at site meetings as necessary including all staff meetings and QA meetings.
3. Provide support through implementation and identification of ways to improve patient experience, streamline work processes, utilize resources more efficiently and reduce potential risk.

• Provide support in the development, design, and modification of the SYH policies and procedures.
• Models excellent interpersonal, mediation, conflict management, communication, and problem solving skills.

Additional Duties and Responsibilities:

• Communicates effectively with participants, co-workers and supervisors
• Enhance professional growth and development through participation in educational programs, current literature, in-service meetings and workshops.
• Exemplify excellent customer service with patients, visitors and other employees.
• Performs other duties as assigned.
• Works effectively in a team setting.
• Adheres to SYHealth attendance and punctuality policies and practices.
• Maintains all records and documentation as required ensuring participant privacy and confidentiality.

Job Requirements:

Education Required (Minimum level of education):

• Bachelor’s degree in healthcare administration or related field.
  

Experience Required (Minimum level of experience):

• Minimum three (3) years’ experience in healthcare risk/quality/medical staff or related experience.
  Must have knowledge of current principles of risk management, patient safety and service excellence.
• Must have the ability to perform duties independently and accurately, including compiling and maintaining complex data and producing timely reports and updates.
• Must have the ability to handle multiple complex tasks with a high level of flexibility and with exceptional time management skills.
• Ability to represent the department with professional appearance and demeanor.
• Recent experience with audits, chart reviews, clinical management, risk management investigations, and report writing strongly preferred.
  

Certifications/Licenses Required:

• Certified Professional in Healthcare Risk Management (preferred)
  

Verbal and Written Skills Required to Perform the Job:

• Excellent oral and written communication skills required; active listening ability and knowledge of adult learning modes required to train, facilitate and motivate various staff in customer service and patient relations quality improvement activities.
  

Technical Knowledge and Skills Required to Perform the Job:

• Proficient in Microsoft Office (Word, Excel, and Access) to write letter to participants and present data in easily understood formats; computer-literate to learn and operate practice management specific applications.
  

Equipment Used:

• Networked personal desktop, laptop computer, tablet, or other hand-held device, document center and telephone.
  

Working Conditions and Physical Requirements:

• Prolonged periods of sitting and standing; driving within the county to travel between clinic locations and to occasional community partner meetings.
• May be required to work evenings and/or weekends.
  

Work Schedule: Full-Time: 40 hours/week
Shift: Monday-Friday, 8:00am – 5:00pm (This is not a remote position)

Universal Requirements:

Pre-employment requirements include I-9, physical, positive background and reference check results, complete application, new hire orientation, pre-employment PPDs. Compliance with all mandated vaccinations and all boosters is a term and condition of employment.