Health Care Risk Manager

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 identity, assess, and treat actual and potential exposures to loss. Assists the Director of Quality and Safety and the Manager of Regulatory Readiness with the implementation of the System-wide Quality and Safety Plan consistent with board approved plans and regulatory and standard setting agencies.

REQUIREMENTS:

• Educates and assists other Managers in assessing their areas of responsibility for exposures to loss and unsafe processes and conditions.
• Investigates all serious events. Assists with communication and documentation of errors or serious events in accordance with legal requirements and/or accreditation standards.
• Acts as liaison to outside agencies such as local, state, federal, or voluntary accrediting agencies.
• 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. C
• 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.
• 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.
• Coordination, oversight, and administration of the Patient Safety, and Grievance Program
• For a full listing of duties, please see complete job description.

 EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

BS required, MS or JD, preferred.

RN or clinical background is required.

Certified Professional in Healthcare Risk Management (CPHRM), preferred.

Two (2) to five (5) years’ experience required, in a healthcare, preferably a hospital setting.

Experience and understanding of Patient Safety, Risk Management, Root Cause Analysis and FMEA Analysis.