Insurance Risk Manager Jobs in Longview, TX (NOW HIRING)

Summary:

In a High Reliability Organization, the Manager, Clinical Risk Management (MCRM) manages, develops, and coordinates the clinical risk management activities for the hospital. In doing so, the MCRM will integrate information obtained from reporting adverse events, near misses, RCAs, and issues related to clinical risk. With this information, the CRM will analyze findings and work collaboratively with system leadership and hospital leaders/managers to develop responsive programs to enhance an organizational culture that supports patient safety, mitigates risks of safety events, and supports the provision of safe, quality patient care. The MCRM will have a dual-reporting structure to both the leader in Quality and the System Director for Clinical Risk Management.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Conducts system analyses to identify patterns that could result in safety and compensable events.
• Assist the ministry in designing programs to mitigate risk of safety events using HRO Principles and Universal Skills to promote the reduction of errors.
• Develops and implements clinical risk management facility policies.
• Directs and performs investigative activities, including but not limited to RCAs, witness interviews and reporting.
• Works closely with the System Legal Claims team to timely report events, obtain assistance in investigations, and assist in potential or ongoing litigation.
• Supports the leadership with performance improvement activities based on the safety risks
• Communicate effectively to different audiences.
• Proficient in computer skills using EXCEL, PowerPoint, MSOffice, and Flowchart tools.
• Knowledgeable on High Reliability Principles and PDSA methodology.
• Knowledge of process improvement practices pertaining to risk management pertaining to a healthcare setting.

Source: NAHQ Workforce Accelerator Competency Framework 2022: Eight Domains

• Quality Leadership and Integration - Advance the organization's commitment to health care quality through collaboration, learning opportunities and communication. Lead the integration of quality into the fabric of the organization through a coordinated infrastructure to achieve organizational objectives. Domain Level: Advanced
• Performance and Process Improvement - Use performance and process improvement (PPI), project management and change management methods to support operational and clinical quality initiatives, improved performance and achieve organizational goals. Domain Level: Proficient
• Population Health and Care Transitions - Evaluates and improve health care processes and care transitions to advance the efficient, effective, and safe care of defined populations. Domain Level: Foundational
• Health Data and Analytics - Leverage the organizations analytic environment to help guide data-driven decision-making and inform quality improvement initiatives. Domain Level: Proficient
• Regulatory and Accreditation - Direct organization wide processes for evaluating, monitoring, and improving compliance with internal and external requirements. Lead the organization's processes to prepare for, participate in, and follow up on regulatory, accreditation and certification surveys and activities. Domain Level: Proficient
• Patients Safety - Cultivate a safe healthcare environment by promoting safe practices, nurturing a just culture, and improving processes that detect, mitigate, or prevent harm. Domain Level: Advanced
• Quality Review and Accountability - Direct activities that support compliance with organization wide voluntary, mandatory, and contractual requirements for data acquisition, analysis, reporting, and improvement. Domain Level: Foundational
• Professional Engagement - Engage in the healthcare quality profession with a commitment to practicing ethically, enhancing one's competence, and advancing the field. Domain Level: Proficient

Job Requirements:

Education/Skills

• Bachelor's Degree of Science in Nursing, or in other clinical degree specialties required.
• Masters degree education with relevant clinical experience and evidence of additional training in patient safety or risk management preferred.

Experience

• 3 years of healthcare experience required.
• 2 years of clinical risk management or patient safety experience required.

Licenses, Registrations, or Certifications

• CPHRM (Certified Professional Healthcare Risk Management) or CPPS (Certified Professional Patient Safety) required or within 2 years of hire.
• Active license if discipline requires licensure.

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time